Doctors, however have found out a way for married couples to enjoy happy conjugal life.
Take less sweets, more fruits and vegetables but not fruit juices or cold drinks. Take care to see that uniformity is maintained in your target glucose levels before and after meals if you are a diabetic patient. If you are not a diabetic patient then take care you don’t become one by curbing pre-diabetes symptoms.
Stimulation of sex glands for the release of Testosterone hormones that lead to improvement of the male sexual organ may be hampered with diabetes. The condition called Hypogonadotropic Hypogonadism was seen to be present in 36% diabetics in north India, according to a recent study the Research Society for the Study of Diabetes in India (RSSDI).
Sex glands in men called gonads or testes secrete chemical substance called Testosterone which maintains sexual functioning. Centrally, the brain sends signals for the release of LH from pituitary glands, which act as triggers for gonads to perform.
Among 200 males aged between 35 to 60 years in the study, levels of Testosterone, LH were significantly low as compared to non-diabetic group.
Diabetes expert at Maharaja Agarsen Hospital and who supervised the study, Dr Rajeev Chawla said ; “we estimate 50% to 60% of middle age men with diabetes suffer from erectile dysfunction. The study results support the belief of high prevalence of ED in diabetics and especially because of interference at brain level in the functioning of sex glands. Correcting hormonal imbalance can help restore healthy sex life in people with diabetes.”
The study suggests Androgen Deficiency in Aging Males (ADAM) Score Test for every diabetic patient 40 years old and more.
ADAM Score Test is a questionnaire based test where the person has to answer 10 questions. It establishes early signs of erectile dysfunction.
Ten questions of ADAM Score Test are –
1.Do you have a decrease in libido?
2.Do you have a lack of energy?
3.Do you have a decrease in strength or endurance?
4.Have you lost height?
5.Have you noticed a decreased enjoyment of life?
6.Are you sad or grumpy?
7.Are your erections less strong?
8.Have you noticed a recent deterioration in your ability to play sport?
9.Are you falling asleep after dinner?
10.Has there been a recent deterioration in your work performance?
Affirmative answers to questions 1 or 7 or to any 3 other questions provide a positive case for ADAM.
Definition of control in diabetes takes a new stance with Glycemic variation being added as a vital condition to be prevented in the management of diabetes. This comes after the conclusion that fluctuating levels of glucose, even in diabetics with tight glucose control, pose a great risk for heart disease.
Calling this as need requiring urgent action, the President of the Delhi Chapter of RSSDI, Dr Rajeev Chawla said : “By Glycemic variation we mean non-uniformity in target glucose levels before and after meals in diabetic patients. This may be frequent but still can go unnoticed in control markers like glycosylated Haemoglobin (HbA1C). This variation is capable enough to cause injuries in blood vessels causing dysfunction of many associated organs or parts specially heart, eyes and kidney.”
According to International Diabetes Federation (IDF), India is expected to cross 100-million mark for diabetic patients by the year 2030.
Dr Chawla said “Delhi has a prevalence rate of 11% and is affecting both urban and as well as rural population. Pre-diabetes is also rampant and most importantly it is estimated that more than 35% of people with pre-diabetes get converted to T2D.”
The Secretary of the Delhi Chapter of RSSDI, Dr BM Makkar said : “Diabetes is a metabolic disorder where there is a misbalance between insulin and glucose. From lifestyle changes to therapeutic intervention, management of diabetes is to balance glucose and insulin. If any new situation arises like fasting or heavy snacking, the balance is broken and blood glucose may vary between high and low causing relative damage.”
According to Dr Makkar obesity is single most independent risk factor for diabetes and is rising in all age groups. It is a dangerous sign which needs focus on newer methods to tackle it, from programmes for patients to newer anti-obesity agents in horizon.
The National Secretary of RSSDI and Head of the Department of Endocrinology in GB Pant Hospital, Dr SV Madhu said : “As a new addition in the protocol, alongwith multi-point monitoring by doctor, patient counseling will be of utmost importance. A dietary change in diabetes is not only about avoiding sugar. Not skipping meals is as important as not taking food items with high calories or Glycemic index.”
He advocated the role of central insulin resistance and new markers associated with glucose in the body.
India has 62.4 million diabetics in 2011 as compared to 50.8 million in 2010 according to IDF and is expected to rise to 100 million by 2030. Nationwide average prevalence of T2D is 9% with Delhi at 10.9%. The prevalence is seen high in urban areas but also seen growing in rural areas. Impaired Glucose Tolerance (IGT) is mounting with an prevalence of 9% in urban areas and 7.8% in rural areas. It is estimated that 35% of IGT will be converted to diabetics, therefore adding to the disease burden.