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Posing Threats to the Male Ego

Since time immemorial, men have been depicted as pillars of strength. For men, it is almost taboo to show pain or suffering—both associated with weakness. There are things men can fight off, but there are just some things that they may just succumb to, and one of these is diabetes.

Diabetes hits women as well as men. However, in this issue, we put the men on center stage and divulge how diabetes can give a big blow to the male ego if not taken seriously.

Males vs. females
According to Dr. Gabriel V. Jasul, an endocrinologist at the St. Luke’s Medical Center and treasurer of the Philippine Society of Endocrinology and Metabolism (PSEM), the risk factors, like family history, are the same for both sexes. But the difference lies in their medical check-ups. “Most men will not consult right away, so there is late diagnosis. Unlike females, they usually go to the OB, so the diagnosis is given early,” says Dr. Jasul.

Dr. Jasul also says that males try to act strong therefore they tend to downplay their symptoms. When doctors check on male patients, the symptoms are already worse, and there might be underlying problems already. He mentions how three problems could be interconnected—hypogonadism (or lack of the male hormone testosterone), diabetes, and heart disease.

One-third of men with diabetes have some form of testosterone deficiency. On the other hand, in men with testosterone deficiency, a high prevalence of diabetes could be noted. “So it seems that testosterone itself, when it’s lacking in the male patient, can contribute some form of risk for diabetes or the metabolic syndrome*,” shares Dr. Jasul.

In addition, a local study conducted by Dr. Mary Ann Lim-Abrahan and colleagues confirmed that there is higher rate of testosterone deficiency in males with diabetes.

Sexually challenging?
Dr. Jasul warns men to have good control over their diabetes to prevent sexual problems. He says that due to low testosterone, chances are that men with diabetes may have difficulty having children. However, not all men would suffer from this unless the problem lies with the testicles.

Andropause is something for men to consider. Compared to menopause, which is symptomatic in women, andropause can be asymptomatic. Dr. Jasul says that this is a normal part of aging, but it doesn’t mean that younger men shouldn’t prepare for this. “The onset of partial androgen deficiency ups the chances of metabolic syndrome—central obesity, high risk of hypertension, diabetes, and high cholesterol,” states Dr. Jasul.

Other characteristics of partial androgen or testosterone deficiency are loss of secondary sex characteristics (such as loss of facial and body hair) and decreased muscle mass. But for those with uncontrolled diabetes, they can manifest with pale, dry, and yellowish skin, and can have no muscle mass.

The dreaded erectile dysfunction
Besides having low testosterone levels, one of the dreaded manifestations of diabetes in men is erectile dysfunction (ED). Dr. Jasul says that stress, heart disease, hypertension, and hypogonadism, can be some of the factors that could cause ED. For those with diabetes, especially those in the later stages of the disease, ED can be devastating.

Aside from dealing with the emotional burden of having diabetes, the additional stress brought upon by ED can be too much for some men to bear. Not being able to perform sexually can be a big blow to the male ego. And this, says Dr. Jasul, is one of the reasons why men are embarrassed to consult their doctors.

No matter how big the impact is emotionally, men would have to deal with ED one way or the other. That ED makes one less of a man is a common misconception, and should be addressed at once. “If you’re looking at the male ego when you cannot perform sexually, this has an impact on their character. They think they’re masculinity gets diminished,” states Dr. Jasul.

Dr. Jasul says that the best way is still to prevent having diabetes. He adds that weight gain or obesity could also contribute to ED later on in life. However, there are some medications that can help solve ED, and not have a negative effect on their diabetes.

One of these is the popular pill, Viagra, however it must not be used on a regular basis. Dr. Jasul says that there are ongoing studies to prove that the pill can be chronically used as a “symptomatic treatment”. But as of now Dr. Jasul says, “It’s mainly a medication to address the problem of the blood vessels, because it dilates them and so it improves circulation.”

Other sugar-related problems
Aside from hurting the male’s sexual side, Dr. Jasul delves on the other physical manifestations of diabetes. He says that if the blood sugar levels of those with diabetes are not controlled, patients tend to be lethargic, lose a lot of weight, and can have very weak resistance.

Having uncontrolled blood sugar can lead to serious complications. And if improperly treated, these complications may lead to death. “Well, the eventual cause of death among many diabetics will be heart disease, heart attack, and heart failure. That’s the main problem because when you look at the general population, if you have diabetes the risk of having heart disease is two to five times higher compared to those who do not have diabetes,” states Dr. Jasul.

Seeing the gravity of the situation, the whole family ought to give full support to the patient. Dr. Jasul says that if the man is married, the support of the wife is very important. “So most of the time what we do is we encourage them to seek the help of the professional. The wife can be of help when it comes to supporting the men to get a medical check-up,” he shares.

Educating men on diabetes
“The most important thing is for the male patient to have a general check-up. The best treatment is prevention. So if we can get ahead of the diabetes, we can prevent the complications of diabetes also,” states Dr. Jasul. Male patients must set aside pride or shame to tell doctors about their symptoms. The earlier they tell their doctor, the easier it is to prevent the complications.

Aside from general check-ups, Dr. Jasul also suggests that men take on a healthy lifestyle. He says that a healthy diet, regular physical activity, minimizing alcohol intake, and smoking cessation can help a lot in preventing or controlling diabetes.

But for those who are already diabetic, Dr. Jasul says that it is important to make sure that blood sugar, blood cholesterol and blood pressure levels, and weight are all within the recommended parameters of their doctors.

With this, Dr. Jasul shares the programs of the PSEM, one of them is the “Hawak Kamay Laban sa Diabetes”. He says that it is a diabetes awareness campaign and diabetes prevention program where, “we give lectures to the lay, and to the barangay health workers to promote diabetes awareness and prevention. We also have modules for this program.”

All of these efforts are for the education of Filipinos, both male and female, on diabetes. Learning about proper ways on how to have good control over diabetes can help improve one’s quality of life. “You can actually live a near normal life even if you’re diabetic; it’s just a matter of adjusting to your medication, to your diet, and major lifestyle changes. It doesn’t mean that you cannot enjoy life; you can actually have a full life even if you have diabetes,” says Dr. Jasul.

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