As diabetes educators, we talk with our patients everyday about preventing and treating the complications of diabetes. We talk about heart disease, neuropathy, foot care, retinopathy and kidney disease all the time.

But do we talk as openly and frequently with our patients about erectile
dysfunction (ED)?

Some of us have questions about ED on our assessment forms, but do we
follow-up with a discussion on the topic? When was the last time you talked with your patients about ED? Have you ever? As professionals and CDE’s, we just simply need to get over it and get on with it. 

ED is quite common in our patient population. Diabetes, hypertension, dyslipidemia and tobacco use are referred to as the erection busters, or factors that can increase the risk of ED. Most of our patients have 3 out of 4 of these factors.

Men with diabetes tend to develop erectile dysfunction 10-15 years earlier than men without diabetes. Above the age of 50, the likelihood of having difficulty with an erection occurs in 50-60% of men with diabetes; above the age 70, the likelihood increases to 95%.1

The silver lining

  • ED is sometimes the symptom that brings a male patient into the doctor’s office that allows the diagnosis of diabetes. We know that ED and diabetes are highly associated, thus the sooner we can get treatment started for diabetes, the better.2
  • ED can be the earliest indicator of vascular damage. ED is an independent risk factor for future cardiovascular disease, peripheral vascular disease and stroke. ED precedes these conditions by 3 years. By talking about ED, we can warn people that they are at risk and
    hopefully encourage behavior change.3
  • A healthy lifestyle can help. Diabetes educators encourage patients to get daily physical activity, eat a healthy diet, manage blood sugar levels, lose weight if overweight and stop smoking if needed. All these healthy lifestyle changes can help prevent nerve and blood vessel damage that can lead to ED. If we slow the progression of diabetes, we may slow the progression of ED.4
  • Many men are reluctant to discuss erectile dysfunction, and that is why it is even more important for diabetes educators to bring up the subject. We can share valuable information and encourage them to discuss options with their physicians.

How to bring up the subject of ED

The best advice is simply to be direct and up-front. Here is a three-step process:

  1. Start with “did you know?”
  2. Ask directly “has this ever happened to you?”
  3. And then provide the encouragement to seek help, to talk with their physician, and to learn more about treatment options.

Suggestions for the “Did you know?” conversation starter:

  • Treating diabetes is an excellent way to prevent future ED.
  • Diabetes, heart disease, and problems with erections are all linked.
  • Changes with your erections can be a warning sign for serious heart concerns.
  • More than 50% of men with diabetes have sexual troubles. You are not alone.
  • There are a variety of treatment options, not only the little blue pill.
  • The American Diabetes Association has published an excellent book on ED and related sex issues entitled Sex and Diabetes: For Him and For Her, by Roszler and Rice.5  This may be a great resource for you and your partner.

A major motivator

A discussion about ED prevention may be the motivator to encourage men to make significant lifestyle changes and take better care of their health. And once ED has occurred, encouraging treatment can positively impact a man’s self-esteem and dramatically enhance quality of life. Certified Diabetes Educators can make a difference!