Diabetes in Men Often Goes Under the Radar

The rate of undiagnosed diabetes mellitus (DM) is high in men even though the overall risk of DM in men is not particularly high, perhaps because men do not like to talk about health issues. That’s one of the messages of a new American Diabetes Association (ADA) campaign designed to raise health awareness among men when it comes to conditions like DM, sexual dysfunction, and sleep apnea as the association celebrates Men’s Health Month in June.

“When it comes to men and diabetes management, the main barriers to good health are often a lack of understanding and education of the disease, as well as a fear of having to change their current lifestyle,” said Robert E. Ratner, MD, FACP, FACE, Chief Scientific & Medical Officer of the ADA. “During Men’s Health Month, the American Diabetes Association is encouraging all men to get out, get active, and get informed to help Stop Diabetes®.”

Nearly 1 in 8 American men has DM, and 1 in 3 has prediabetes. The complications of DM are well known and serious, and those risk factors can be controlled significantly through control of the ABCs: A1C (as a measure of glucose control); blood pressure; and cholesterol, particularly low-density lipoprotein. The health risks for men who have DM who smoke are even greater than the risks for men who do not, so smoking cessation is even more important. Studies show an increased risk of heart disease for men both with and without DM.

An easy-to-implement screening score for undiagnosed DM, defined as fasting plasma glucose level of 7.0 mmol/L (126 mg/dL) or greater without known DM, was developed from National Health and Nutrition Examination Survey data. The instrument has been demonstrated to be an improvement over existing methods.

Historically, men have not been comfortable when it comes to discussing health issues, which can result in shorter and less healthy lives, the association said.

Being male also means being more likely to suffer from obstructive sleep apnea (OSA). Cross-sectional studies have documented the co-occurrence of OSA with glucose intolerance, insulin resistance, and type 2 DM. OSA is linked to an increased risk of DM and can make DM harder to control. Studies show that sleep apnea increases the risk of DM, independent of other risk factors. Among patients with more severe sleep apnea, regular positive airway pressure use may attenuate this risk. In addition, DM often has sexual implications for males, including erectile dysfunction.

However, men can take many steps to better care for their DM and general health. The ADA recommends finding a family doctor the patient can trust and discussing health issues. In addition, the association recommends enlisting a friend or family member to help the patient adopt healthy behaviors, such as an exercise partner, to increase the level of physical activity and modify eating habits and portion control.

The ADA notes that regular professional care is crucial for keeping DM management on track.