Diabetes mellitus is a metabolic condition in which patients have abnormally high serum glucose due to either a lack of insulin or because the body cells are unresponsive to the effects of insulin even if there is normal production of the hormone. Diabetes is grouped into two classifications: type 1 diabetes and type 2 diabetes. Individuals with type 1 diabetes have an total lack of insulin in their body due to the failure of the pancreas to produce it. People affected with type 1 diabetes require daily insulin injections as treatment. In contrast, type 2 diabetes which is the more common form, results from a relative lack of insulin; the primary defect is the unresponsiveness of cells to insulin. The classic symptoms of diabetes include polydipsia, urinary frequency and polyphagia. Weight loss is also common among type 1 diabetics, as well as recurrent blurred vision, weakness and fatigue. numbness in the extremities may be a late symptom that signals nerve damage due to diabetic neuropathy. Patients with type 1 diabetes are prone to diabetic ketoacidosis, a life-threatening acute metabolic dysfunction that can lead to coma and death if insulin replacement is not instituted immediately. Type 2 diabetes usually progresses slowly and may go undiagnosed for years since patients are initially without symptoms. Chronic skin infections are common in many patients with type 2 diabetes; women commonly present with chronic Candida vaginitis. Men who are previously undiagnosed with diabetes may also present with erectile dysfunction. In majority of patients with diabetes, a number of complications arise during the course of the disease. The most common target of diabetic complications is the vascular system which affects both the small and large blood vessels. Generally, changes that occur include thickening of the blood vessels in the eyes which leads to diabetic retinopathy, or in the kidney that causes secondary nephropathy. In diabetes large vessels become atherosclerotic which increases the risk of stroke and myocardial infarction. Autonomic neuropathy is also a common complication that affects chronically affected diabetic patients. Symptoms of autonomic neuropathy secondary to diabetes include increased heart rate even at rest, constipation, diarrhea, urinary continence and impotence. The erectile dysfunction caused by diabetes is part of the complications in the nerves as well as the blood vessels. An erection is achieved by a combination of blood flow to the corpora tissues of the penis that fills with blood during arousal and sensory plus autonomic signals to the brain and back to the sacral autonomic nerves. Impotence occurs if there is an inability to initiate or sustain an erection of satisfactory duration and firmness required to complete sexual activity. How exactly does diabetes cause impotence? Since high blood sugar causes blood vessel damage, the release of nitric oxide is affected. Nitric oxide is a chemical that is produced by cells that line the blood vessels and it functions as a chemical stimulator in the arteries of the penis that cause relaxation of the vessels and enhances blood flow for a prolonged and sustained erection. With diabetes, sexual response is inhibited because of impaired release of nitric oxide thus blood flow to the penis is decreased. The anatomic defect in the blood vessels caused by atherosclerotic changes due to diabetes may also contribute to erectile dysfunction. Reduced blood flow to the penis can also be caused by hypertension that is common in diabetic patients, as well as cholesterol deposits that further damage and reduce blood flow to the penile tissues. Diabetic impotence is reversible with good control of glucose levels in the blood. As long as the blood supply to the penis is intact, men affected with diabetes are physically capable of achieving and sustaining an erection. Drugs such as Viagra and Cialis can help but controlling blood sugar in diabetic patients is the best way to counter impotence.
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DM is a metabolic condition in which affected people have abnormally high serum glucose due to either a lack of insulin or because the body cells are resistant to the effects of insulin even if there is normal production of the hormone.
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