How to balance diabetes and reproductive health in men

Diabetes is essentially an issue with the body’s capacity to control blood sugar levels because of low or ineffective insulin levels. Type I and Type II diabetes mellitus are the most prevalent varieties of the disease. Those with diabetes are more likely to experience erectile dysfunction than men with appropriate blood glucose control.
Erectile dysfunction affects two in three Type II diabetic men and one in three Type I diabetic men. Men with diabetes typically have lower testosterone levels than men without the disease, which can have an impact on their energy levels, sex drive, and mood. 

Symptoms of diabetes 
l Heightened thirst 
l Urinating often and feeling exhausted and lethargic 
l Distorted vision 
l Loss of weight (in severe cases) 
l Increased appetite 
l Rising infection rates (especially of the skin; e.g., thrush) 
l Delayed healing of a wound 

Types of Diabetes
In the human body, during digestion, the pancreas releases insulin to regulate blood sugar levels. Extra sugar builds up in the bloodstream and leads to diabetes when the body is unable to transport the glucose into its cells, where it can be used for energy. In autoimmune type 1 diabetes, the cells that produce insulin are destroyed.
Pre-diabetes is characterised by improper sugar processing by the body, which results in elevated blood sugar levels but not yet type 2 diabetes. Type 2 diabetes develops when the blood sugar levels are not properly regulated. This occurs when the body develops an immunity to insulin or the pancreas is unable to produce enough insulin to control blood sugar levels.
We frequently hear about the negative effects diabetes has on health. It may have an impact on the reproductive system in addition to major medical concerns like obesity, kidney damage, and cardiac risk.
If diabetes is not adequately managed, it can harm blood vessels and nerves, raising the risk of infection. Men with pre-diabetes (higher than usual blood sugars) have been reported to have low testosterone levels, increased sperm DNA damage, and occasionally azoospermia (absence of sperm). Low sperm counts, erectile dysfunction, and libido can all be caused by hypogonadism (low testosterone levels) (decreased sex drive).
Balanitis (inflammation of the tip of the penis) and issues with ejaculation have also been connected to diabetes.

Diabetes affects each person differently, so each patient’s treatment must be different. While some individuals can control their diabetes with diet and exercise, others will require medication for the rest of their lives.
Men who have a history of diabetes in their family are advised to get themselves tested if they are planning on starting a family. Semen analysis and the sperm DFI (DNA Fragmentation Index) test can show the quality of the sperm and if it can be linked to high sugar levels.
You should seek the guidance of your fertility specialist. They can guide you on the lifestyle changes that can be made, which can control your diabetes to some extent, and they can help you get the appropriate medical interventions as well.
Dr Rohit Gutgutia is Medical Director at Nova IVF Fertility, Eastern India.

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