A look at the relationship between men and diabetes

While type 1 diabetes (t1d) touches people of all shapes, sizes, and walks of life, there's a unique connection between men and diabetes. In fact, previous research has found a higher incidence of t1d in men. While women definitely have their own concerns related to the condition, men living with t1d can also face special challenges.

However, there's no reason anyone has to let these challenges prevent them from living an active and fulfilling life. I'm happy to report that I've been able to enjoy just as much as the next guy — I've just needed to be a little more thoughtful about certain situations and activities.

Here are answers to common questions about living with t1d as a man.

Are guys with T1D prone to erectile dysfunction?

Yes, it's been found that men with t1d are more likely to experience erectile dysfunction (ED) than other men. ED is present in more than one-third of men with t1d and at three times the rate of men without diabetes, according to a study in Diabetic Medicine.

One reason why t1d makes men more vulnerable to ED is that high blood sugar can damage the nerves and blood vessels needed to have an erection. Additionally, men with low levels of the hormone testosterone (low T) are also more likely to have ED — and men with diabetes are twice as likely to have low T.

Other risk factors for ED can include diabetic neuropathy and mental health issues such as depression.

Fortunately, there's good news about men and diabetes: Guys with t1d can take steps to prevent ED and have active sex lives. This can be achieved by properly managing blood glucose levels, as keeping numbers in a healthy range can help prevent the nerve and blood vessel damage that contributes to ED.

This is a good reason to use advanced diabetes technologies, such as continuous glucose monitors (CGMs) and insulin pumps, which can automate your daily management. A number of medications and other treatments are also available for ED. Men living with t1d should consult with their healthcare providers to find the approach that works best for their individual situations.

Does T1D affect male fertility?

Yes, studies have shown that t1d can also have detrimental effects on male fertility. That's because t1d can impact the quality and composition of sperm.

"Male infertility is a well-known complication of diabetes, particularly when blood sugar levels have not been well controlled," said Timothy Hsieh, an endocrinologist with Kaiser Permanente.

But here's a reassuring truth about men and diabetes: No matter what the statistics say about the quality of their sperm, many men with t1d can have kids. In fact, I live with t1d and also have a healthy daughter. She's the best thing that ever happened to me.

How does puberty affect guys with T1D?

Young men living with t1d can experience extra challenges during puberty. During their transition to adolescence, male teenagers tend to have higher levels of testosterone, which can raise blood sugar levels. Having too much testosterone for too long can prompt insulin resistance among young men with t1d, which means more insulin than usual is needed to cover the carbs eaten. In fact, insulin can be 30% to 50% less effective during puberty.

Furthermore, the teenage years are often accompanied by mood swings, the sense that life is hard to control, and generally rebellious behavior. It's no wonder that adolescents with t1d lag behind other age groups when it comes to blood sugar control, according to a study in JAMA.

The study also showed that CGMs are effective at improving the diabetes management of teenagers with t1d. Taking advantage of this technology is one way to boost the health and well-being of adolescent males (and men of all ages who live with t1d).

Are there differences in T1D management between sexes?

Although there are hormonal differences between men and women with t1d, the fundamental tasks involved in good diabetes management are the same for both sexes. Insulin doesn't care about sex; it acts the same way in all people. Anyone can live life to the fullest if they take care of themselves and manage their diabetes effectively.

Looking for more information about navigating life with type 1 diabetes? Check out the Health Insights blog for more guidance and advice.