Threat of impotence accompanies diabetes

Ridlo Aryanto, Contributor, Yogyakarta

Pramono is no longer the man he used to be. The 42-year-old is now skinny and looks weak for a man of his age. The thing is, he has had diabetes for five years.

According to the man's wife, Sunarti, the glucose level in Pramono's blood is very high.

"He has to adhere to a very strict diet, eating only rice or boiled potatoes and vegetables," Sunarti said while accompanying her husband to Bethesda Hospital in Yogyakarta for a checkup.

For the couple, the problem is more than just regular checkups. "Being weak like this makes it impossible for me to be the husband I should be. I'm never in the mood (for sex), which is upsetting for my wife," Pramono said.

According to a professor in neurology at Gadjah Mada University's School of Medicine, Samekto Wibowo, diabetes might cause impotence, especially if it is acute.

"It's true that someone who has had diabetes for over two years might experience erectile dysfunction, or impotence. It happens because of diabetic neuropathy, or dysfunction of one or more of the peripheral nerves resulting from the high increase of sugar in the blood," Samekto said.

Diabetic neuropathy, according to Samekto, is a clinical or subclinical disorder that is often found in diabetic people.

Research he once conducted of people with diabetes mellitus showed that there was a high possibility of them experiencing diabetic neuropathy, which could led to impotence.

"The possibility ranges from between 5 and 50 percent for those who have had the disease for two to 10 years," Samekto said. Those who have had the disease for over 25 years have higher a probability of over 50 percent, he added.

Citing research conducted by Gefen and Spollet in 1999 as reported by NeuroSains magazine, it states the prevalence of impotence among diabetes mellitus sufferers is up to 75 percent, and could occur earlier for those over 60 years old.

The question is, how is impotence related to diabetic neuropathy?

According to Samekto, it is the damage in the secondary nerve resulting from chaotic metabolism in diabetics (due to the high glucose level in the blood) which causes impotence.

The damage, Samekto says, leads to a synthetic process and the formation of lipid myelin composition -- one of the main cells in the nerve that causes synthetic disturbance in the protein and damage the nerve cell.

"Once the nerve cell is disturbed, it will also disrupt the function of the nerve. And when such a problem continues, the erection process will also be disrupted," he said.

In this case, he said, the first important thing to do is to treat the symptom by controlling the level of glucose in the blood. In other words, a strict sugar-controlled diet is needed.

"Diet is important, but it has to be carefully controlled to meet the exact, desired dosage," he said.

Additional medicine is needed only under certain circumstances. For example, when there is permanent damage in the nerve cords directly connected to the erection process.

"But don't let it bother you and make you give up the effort of trying to get better even when it (the permanent damage) has already happened," he said.

"Sexual activity covers a very small percent of people's activities. The failure of a man in performing his job as a husband, in this case providing sexual satisfaction for his wife, does not mean the end of the world."