More than 50 percent of diabetic men suffer from impotence, and almost all complain bitterly that it has destroyed something that is very important to them. Impotence caused by diabetes can be prevented or reversed in almost all men whose bodies can still make insulin.

Diabetes causes horrendous nerve damage including blindness, deafness, burning foot syndrome, loss of feeling, loss of muscle control, pain and tingling and impotence. The penis is the only gland in the body that has its blood supply shut off all the time. Muscles surrounding the penile artery constrict the artery to prevent blood from flowing to the penis. When a man is excited, his brain sends messages along nerves that cause the nerves to secrete a chemical called nitric oxide theat relaxes the muscles around the arteries to open blood flow to the penis and the balloons in the penis fill with blood and the man has an erection.

More than 90 percent of diabetics who can still make their own insulin can be controlled so that they do not suffer nerve damage. When you eat, your blood sugar level rises. If it rises too high, sugar sticks to cells and causes permanent nerve damage. Doctors can measure how much sugar is stuck on cells with a blood test called HBA1C. To get your HBA1C to a normal range below 6.1, you have to avoid foods that cause a high rise in blood sugar such as those with added sugar, those made from flour such as bakery products and pastas, and fruit juices.

Most cases of nerve damage from diabetes can be reversed by good control of diabetes, but sometimes the damage is permanent. For example once person goes blind from diabetes, he will never get his vision back. However, impotence is often reversible with good control of diabetes.

Men who are impotent from diabetes must be seen every month and each month, the doctor must draw a blood test called HBA1C which measures diabetic control for the last 12 weeks, or another blood test called fructosamine, which measures diabetic control over the last 2 weeks. Every time, the HBA1C is greater than 6.1, the doctor must change the patient's drugs and the patient must change his diet.

All diabetics should get a blood test called C-peptide to tell if their bodies can make insulin. If their C peptide is greater than 1, they should not be placed on insulin and should be started immediately on Glucophage and Actos or Avandia. These drugs lower high blood sugar levels, never cause low blood sugar, and also lower insulin to prevent obesity and heart attacks. Only if blood sugar levels cannot be controlled by diet and these insulin-lowering drugs should doctors prescribe drugs that raise insulin.

For my recommendations on treatment of diabetes see http://www.drmirkin.com/diabetes/D222.html

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at http://www.DrMirkin.com

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