Diabetes, the Killer of the Haitian Man’s Erection
Diabetes mellitus (DM) doesn’t mean “Death to Men”, although it is the fifth leading cause of death and results in 5 million deaths per year with increased prevalence in low-income countries such as Haiti. (Khan et al, 2020). According to the International Diabetes Federation, around the world, 425 million people are living with DM, with higher rates of death and complications in blacks or those of African descent.
DM is a chronic disease caused by increased insulin resistance (insulin is a hormone made by the pancreas that facilitates the blood sugar into the cells in the body for use as energy). In DM, the cells do not respond as they should to insulin, resulting in insulin resistance. This sends the pancreas into overdrive to make more insulin to get the cells to respond. The pancreas, in DM, cannot keep up, and therefore the blood sugar levels rise. The poor control of diabetes resulting in high levels of blood sugar causes many health problems including damage to the nerves and blood vessels to the penis resulting in erectile dysfunction (ED).
According to the CDC, as many as 30 million men in the United States are affected by ED. In ED, a man can’t keep or get an erection firm enough for sex.
Haitian men with diabetes are three times more likely to have ED. The symptoms of ED such as difficulty keeping an erection can present before DM is diagnosed. ED can also be associated with other health problems prevalent in Haitian men such as heart disease and high blood pressure.Haitian immigrants tend to bring different practices and eating habits from Haiti, research has shown that personal, and cultural health beliefs govern how individuals manage their diabetes. In addition, just being an immigrant result in increased challenges in accessing health care and facilitating healthy behaviors. Once assimilated into the US culture there’s higher fast-food consumption, lower intake of fruits and vegetables, and an increasingly sedentary lifestyle which increases the risk of diabetes (Ross, 2010).
Haitian men with DM resulting in erectile dysfunction can also experience anxiety, and depression and have feelings of frustration, embarrassment, and discouragement. Haitian men are often very reluctant to seek professional help or discuss ED with a medical provider.
The good news is that although ED is a common problem for Haitian men with DM, it can be treated and prevented.
The first step is to seek help.
Schedule an appointment with a doctor or nurse practitioner as soon as possible.
Working together with a healthcare care provider to manage blood sugar levels under control can decrease damage to blood vessels.
A medical provider will obtain a medical, surgical, and social history. A review of medications will also be performed as some medications can also contribute to ED. All information gathered will be to formulate the underlying causes of erectile dysfunction. Lab tests and radiological studies may also be performed.
If a diagnosis of erectile dysfunction is made in the setting of diabetes, the goal is to keep blood sugar levels under control. A medical provider will discuss the underlying causes of erectile dysfunction and can provide information about medication and other erectile dysfunction treatments.
It is very common for Haitian men with ED to have other medical problems like high blood pressure and heart disease. The management of these health issues should also be addressed.
Stress and anxiety can make ED worse. It can also cause relationship stress. Counseling with a mental health professional can help with strategies to cope.
Treatment for ED for the Haitian man can consist of oral medications to ease blood flow to the penis and make it possible to keep an erection. A suppository can also be prescribed that is inserted in the tip of the penis, before sexual intercourse, or an injection to increase blood flow to maintain an erection can also be prescribed.
A penis pump also called a vacuum constricting device which is a pump to draw blood into the penis to get and keep an erection can also be recommended.
Other options such as penile implants maybe are available from a Nurse Practitioner specializing in Urology or sexual health or by a Medical Doctor specializing in Urology or sexual health.
The best treatment is prevention. The Haitian man with diabetes can prevent erectile prevention by keeping blood sugars under control, not smoking, eating a well-balanced diet, losing excess weight, being physically active, limiting alcohol intake, and managing other chronic health problems.
Johanne Louis, DNP, CRNP, FNP, ANP-C
References
Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. J Epidemiol
International Diabetes Federation. Facts and figures. 2016. https://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures. Accessed 18 June 2018.Glob Health (2020) 10(1):107–11. doi: 10.2991/jegh.k.191028.001
This article is very informative, although, i am a female of african decent, i do know a lot of male friends/colleagues/family members who are in this group. This will be a teaching moment with me and them.
Thank for this insightful article.