June is Men's Health Month, so as one of the 'Mine's men in the trenches, I've been asked to cover what's unique about diabetes and men. You might be surprised to learn that it's not all below the waistline (although some of it is). Diabetes uniquely effects men's bodies differently from women's, and yes — the classic male traits may get in the way of good healthcare as you'd expect.
But don't worry guys, we've got those below the beltline tips you've been wanting, too.
A hundred years ago, if you were a man, you'd live every bit as long as a woman who was born the same year as you were. But that's no longer true. In the USA, women outlive men on average by about five years.
What's up with that? Well, there are a zillion unproved theories, most of them having to do with the classic male personality traits and resistance to seeking medical care.
But it gets more complicated when you plug diabetes into the equation. Diabetes turns out to be much more dangerous to women than to men. These two sets of facts don't seem to jive very well. Could it be as simple as the fact that because women now live longer, they have the opportunity to get felled in greater numbers by diabetes complications, which strike later in life and later in the disease process? Maybe.
But at least for younger men with diabetes (MWDs), or those with type 1s in England, anyway, we find that the death rate for young men is double that of young women. Researchers attribute this wide divide to "macho" attitudes standing in the way of seeking medical care (just be a man about it, right?) and also standing in the way of good self-care behaviors (no business fussing over yourself).
Between the Ears
Attitude comes into play in other ways, as well. Men, like women, are susceptible to depression, anxiety, and stress—all issues that are part and parcel of the diabetes experience. However, men are more likely to internalize "mental" issues, and are even less likely to seek out help for this stuff than for other kinds of health care.
In the Bedroom (Not Like You are Thinking)
Sleep apnea, or brief interruptions in breathing during sleep that wreak havoc on healthy sleep patterns (and may even be a contributing factor in triggering diabetes) is much more common in men than in women. And of course, given the male resistance to getting medical help, it's also more likely to go untreated as well.
Below the Belt (OK, Like You were Thinking)
Fully one third of male type 2s suffer from low testosterone, a guy hormone that in addition to fueling the male sex drive, is also a key player in preventing osteoporosis. There's been a lot of media hype about "Low-T," but the reality is that any man with diabetes should probably have his T-level checked by his medical team.
But of course, it's Erectile Dysfunction (or ED to its friends) that's probably the most male-feared diabetes complication. The stats are sobering: overall, 50% of MWDs suffer from ED. The longer you've had diabetes, and the older you are, the higher the risk—up to 75% of older, long-term MWDs suffer from ED.
Interestingly, there are actually five root causes of ED in men with diabetes. Sort of like a perverted odds-stacked game of Russian Roulette, where only one chamber in six is left empty.
High blood sugar causes ED directly. And nerve damage from high blood sugar also causes ED, by reducing sensation and blocking the nerve signals that trigger the mechanics of the erection. Microvascular damage from high blood sugar causes ED by interfering with the plumbing system that fills and drains the penis. And some meds have the side-effect of causing ED.
While type 2s can and do suffer cardiovascular ED, most MWDs are at higher risk of the nerve-damage flavor of ED. And the little blue pill is powerless to help fix this problem. If you develop neuropathy of the penis, you'll end up being the piano player at the bordello, rather than being a paying customer. Keep your blood sugar down to keep your you-know-what up.
And lastly, ED can be caused by psychological issues as well as physiological ones. Anxiety, stress, and depression are all things that get us down and keep us from getting it up.
On the other side of the male reproductive coin is the (perhaps) unintended consequences of getting it up just fine: passing our diabetes on to our children. Many men with diabetes are reluctant to have children because they worry about giving their disease to their kids.
The risk is real, and how high that risk is depends on who the mother is, too. We've covered the overall odds here, but in general, a type 1 man has about a 6% chance of passing his diabetes along. If there were a 6% chance of rain, would you—as a man—take your umbrella? And frankly, what's the worst that can happen? If your child has diabetes, who better to guide them and teach them than a dad with diabetes?
Type 2 dads have much greater chances of passing along diabetes. However, a type 2 father has the opportunity to teach his children to avoid the risk factors that trigger diabetes early. He can teach his children to eat smart and keep active.
In my personal opinion, to be a real man, I think you must become a father. It gives you perspective and purpose you cannot imagine until you hold your baby in your arms. And even if we sometimes have days we wish we hadn't been born, we don't really mean it; and your unborn kids feel the same way. Don't let diabetes keep you from the greatest and most rewarding challenge of manhood: fatherhood.
Changing the Paradigm
Changing the classic male approach to health is the purpose of Men's Health Month. It's about starting a new conversation, Of finding new ways to define what it means to be a man. Of recognizing that taking responsibility for our own good health, for the sake of our loved ones, is very manly indeed.