Skin and Sexual Problems in Diabetes
About 30 to 35% of Diabetic patients develop skin problems. Because of Diabetes the severity of these infections is more as compare to the Non-Diabetic.
Diabetic patients develop finger infections of Nails, Nail bed, between fingers, inner and part of thigh or at private parts. Some time itching and rash may be presenting symptom of Diabetes in females specially if she is over weight. In males cuts at glans penis indicate increase in Blood sugar.
Sometimes Diabetic patient will have oral ulcers or thrush. Fingers infection of Nails may cause swelling and performation at one side of Nailor destruction of Nail. Sometimes there are ulcers between fingers or toes and it may be so much painful that one cannot wear shoes.
Diabetic men present with redness and swelling of the penis at opening and it is usually associated with sever itching and pain. This is called as Balanitis. There may be difficulty in retracting skin.
In some Diabetic patients because of these problems circumcision is advised.
In all above skin problems antifungal lotions and creams help in solving the problem. All above conditions indicate that the Blood Sugar is not under control and it has to be kept in control.
Sexual Problems in Diabetes
Diabetes is one of the few diseases that can cause impotence, i.e. loss of the ability to achieve and maintain an erection hard enough for sexual intercourse-also called as Erectile Dysfunction (ED).
Erectile Dysfunction is 3 times more common among diabetics than in the healthy control population. Incidence varies ITom 28 to 59%.
Age, duration of diabetes, levels of Blood Sugar presence of complications especially Retinopathy and Neuropathy, high blood pressure and drugs taken for controlling it, smoking and alcohol abuse. Risk of impotence is high in diabetics where Blood Sugar are on very high side and HbA,c is more than 9.8%. Persistent high blood glucose leads to certain chemical changes which, damage arteries and nerves.
Initially, there is diminished Penile rigidity and reduced ability to sustain an erection. This progress to full-fledged failure of Erection. Very often, sexual desire persists.
There is substantial evidence to suggest that Erectile Dysfunction in diabetes is often Psychological in origin. Factors are: awareness of suffering from a chronic condition, relationship problems and fear of failure during sexual intercourse. Many patients don't discuss this problem with their doctor. Only .50% of diabetics having sexual problems discuss with their doctor about it.
How to Manage
First and the most important aspect of treatment is to control Blood Sugar by diet or drug treatment and by persuading the patient to abstain from risk factors iike smoking and alcohol abuse.
Psychotherapy care help to minimize the anxiety and modify the couple's sexual habits in helpful way.
Many drugs are being used for correcting this disorder, Silidenafil (Viagra now available fn Indian Market also) is very effective in controlling Erctile Dysfunctions in diabetic men. It relaxes smooth muscles, increases blood flow and this leads to penile erection.
Medicine is taken 60 minute before intercourse and has an effect lasting about 4 hours. It should not be taken by men taking Nitrates for angina or heart problems like, isosorbide, dinitrate, monotrate etc. It should be taken only after discussion with your doctor. Other common side effects are headache, flushing, stomache and meld temporary visual changes.
Other Drugs and Devices
Certain hormonal treatment or anti-depressants are also useful. Self injection, vacuum devices and surgical implants are the other herapeutics options available which your doctor would suggest to you.
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