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Suggest Treatment For Erectile Dysfunction
Question: Dear Dr
I am 59 married and have two children. I had by pass seven years before and I am a diabetic patient taking insulin. The problem is erection not happening and I have to resort to masterbation while during other acts of sex with my wife. Is there any tablet that I can take which should not affect a heart patient? Now my sugar is under control for the past 3 weeks due to exercise, change of insulin and diet control. At least once in a week sex with wife is essential for happy life I feel. Please advise me
I am 59 married and have two children. I had by pass seven years before and I am a diabetic patient taking insulin. The problem is erection not happening and I have to resort to masterbation while during other acts of sex with my wife. Is there any tablet that I can take which should not affect a heart patient? Now my sugar is under control for the past 3 weeks due to exercise, change of insulin and diet control. At least once in a week sex with wife is essential for happy life I feel. Please advise me
Brief Answer:
Controlled Diabetes, anti-oxidants , Urologist's
Detailed Answer:
Hi.
Thanks for an elucidate history.
As I could get from the history you have given about bypass, diabetes, insulin, control for 3 weeks and ED for many months.
It is true that you should not take any medicines that can affect the heart so Viagra and the likes are out of question- in fact contraindicated in your case.
It looks to me that the Erectile dysfunction is there for some months only. This is most probably due to the uncontrolled diabetes.
We have seen many patients to have improved libido and sexual satisfaction after a proper control of diabetes, albeit this can not occur overnight. I am sure that if you maintain perfectly controlled blood sugars , there will be a good improvement.
In addition you can certainly consult an Urologist to see for the causes, investigations like color doppler for penile blood flow, prostate as may have enlarged with age as a normal aging process and a proper treatment accordingly.
Take multivitamins supplements as are anyway necessary in all patients of diabetes and cardiac problem as they act as anti-oxidants.
Controlled Diabetes, anti-oxidants , Urologist's
Detailed Answer:
Hi.
Thanks for an elucidate history.
As I could get from the history you have given about bypass, diabetes, insulin, control for 3 weeks and ED for many months.
It is true that you should not take any medicines that can affect the heart so Viagra and the likes are out of question- in fact contraindicated in your case.
It looks to me that the Erectile dysfunction is there for some months only. This is most probably due to the uncontrolled diabetes.
We have seen many patients to have improved libido and sexual satisfaction after a proper control of diabetes, albeit this can not occur overnight. I am sure that if you maintain perfectly controlled blood sugars , there will be a good improvement.
In addition you can certainly consult an Urologist to see for the causes, investigations like color doppler for penile blood flow, prostate as may have enlarged with age as a normal aging process and a proper treatment accordingly.
Take multivitamins supplements as are anyway necessary in all patients of diabetes and cardiac problem as they act as anti-oxidants.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I wish to consult a XXXXXXX Diabetic Specilist Doctor( since I am taking XXXXXXX Medicines and Insulin available in India) on my insulin dependent diabetic. Though the fasting sugar level was under control post food level was not controlled. The average for 4 months comes to 10.2 as per H1A1c (?) Others are oK.
Now from July, I changed the Insulin Lantus with TRESEBA.
Morning Diamacron 10 mg before food and Novamix 50:50 10 units and after breakfast Galvusmet 50/500 plus Cardace 5 mg for Bp. I take Centrum Vitamin tablet in the morning after food. Morning I take vegitable mix ots at 8.30 am, 11 am two biscuirts and coffee, lunch with little rice and vegitable, evening 5 two biscuits and coffee ( coffee with coffee mate and no sugar always) Night I take Ragi Dosa 3,
Night Diamacron before food and insulin Lantus 30 units at night. July, as per doctor advise, I changed Lantus to TRESIBA 25 untis daily in the night after food for 300 units and then came back to Lantus. I am going for regular walk of 20 minutes in moring and 20 minutes in eve most of the days.
Also Galvusmet 50/500 two times after food( morning and night). After 15 days of walk, and diet also morning veg soup with oats, 11 coffee with 3 biscuits, lunch little rice and veg, 5 pm coffee with 3 biscuts and night 3 or 4 ragi dosa.
last two days the sugar reading was post break fast after one or one and halff hour it came to 137 and today 125.
My question is can I reduce the Insuling unit intake... say morning 5 of novamix and night 20 of lantus and try the readings?
What is the reading for fasting, post break fast and post lunch and in the evening? Please advise me.
Now from July, I changed the Insulin Lantus with TRESEBA.
Morning Diamacron 10 mg before food and Novamix 50:50 10 units and after breakfast Galvusmet 50/500 plus Cardace 5 mg for Bp. I take Centrum Vitamin tablet in the morning after food. Morning I take vegitable mix ots at 8.30 am, 11 am two biscuirts and coffee, lunch with little rice and vegitable, evening 5 two biscuits and coffee ( coffee with coffee mate and no sugar always) Night I take Ragi Dosa 3,
Night Diamacron before food and insulin Lantus 30 units at night. July, as per doctor advise, I changed Lantus to TRESIBA 25 untis daily in the night after food for 300 units and then came back to Lantus. I am going for regular walk of 20 minutes in moring and 20 minutes in eve most of the days.
Also Galvusmet 50/500 two times after food( morning and night). After 15 days of walk, and diet also morning veg soup with oats, 11 coffee with 3 biscuits, lunch little rice and veg, 5 pm coffee with 3 biscuts and night 3 or 4 ragi dosa.
last two days the sugar reading was post break fast after one or one and halff hour it came to 137 and today 125.
My question is can I reduce the Insuling unit intake... say morning 5 of novamix and night 20 of lantus and try the readings?
What is the reading for fasting, post break fast and post lunch and in the evening? Please advise me.
Brief Answer:
Insulin dependent- do not reduce dosage of Insulin
Detailed Answer:
Well,
You do not an XXXXXXX Diabetic specialist because the medicines are of XXXXXXX origin, Sir. ( you would have mentioned this in the original question). You must have been under a care of a Physician or a Diabetologist at the moment. As a Surgeon we do come across diabetic patients with complications to be treated by us.
HbA1c of 10.2 is definitely high and this has to be brought down by proper dose adjustments of Insulin.
Since you are Insulin dependent there is no way you can think of reducing the dosage of Insulin. You should not alter the dosage without the consent of your treating Doctor, who should be aware of every single development for Him to help you have a proper control which is important for your ED too.
The various readings at different levels are Lab-dependent, meaning all the laboratory equipment are calibrated and their standard normal ranges will differ from lab to lab, so I would request to consult the reports given by your present laboratory from where you are doing your tests. Even though you may be using your home-kit , it should be calibrated and compared with your regular laboratory and you should not change it.
You an have a regular charting of blood sugar and other investigations in a diary of all your reports. This helps your Doctor a lot. Have the challenge of reducing HbA1c to normal within the next three months. ( this reading shows the average for the last 3 months gone-by)
Liked your way of exercise and food habits. You may increase the walking distance or pace. This is very important for circulation purpose.
Please feel free to ask for more if you need to .
Insulin dependent- do not reduce dosage of Insulin
Detailed Answer:
Well,
You do not an XXXXXXX Diabetic specialist because the medicines are of XXXXXXX origin, Sir. ( you would have mentioned this in the original question). You must have been under a care of a Physician or a Diabetologist at the moment. As a Surgeon we do come across diabetic patients with complications to be treated by us.
HbA1c of 10.2 is definitely high and this has to be brought down by proper dose adjustments of Insulin.
Since you are Insulin dependent there is no way you can think of reducing the dosage of Insulin. You should not alter the dosage without the consent of your treating Doctor, who should be aware of every single development for Him to help you have a proper control which is important for your ED too.
The various readings at different levels are Lab-dependent, meaning all the laboratory equipment are calibrated and their standard normal ranges will differ from lab to lab, so I would request to consult the reports given by your present laboratory from where you are doing your tests. Even though you may be using your home-kit , it should be calibrated and compared with your regular laboratory and you should not change it.
You an have a regular charting of blood sugar and other investigations in a diary of all your reports. This helps your Doctor a lot. Have the challenge of reducing HbA1c to normal within the next three months. ( this reading shows the average for the last 3 months gone-by)
Liked your way of exercise and food habits. You may increase the walking distance or pace. This is very important for circulation purpose.
Please feel free to ask for more if you need to .
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr
Thanks for your reply.
I will coonsult my diabetologist soon. But I am not fully convinced of your answer. This is not encoraging for a person who after all the health problem could reduce the sugar level which is true and asking for reducing the intake of insulin as one day with the current dosage it came to 70 by 12 noon and got sweat due to hypoglumacia and I had to rush to my home and take some sweets and it took hours to calm down. I felt the dosage of insulin is higher as I only increased it after readings were found higher. I had a history of severe back pain L4 L5 and I could not walk or stand in a place for a long time. Now that over 3 weeks I am able to walk in brisk way for 20mts say about 4 km in morning and in the evening. A patient like me, what is motivating? it is the will power to control and I found out it is getting controlled and it is getting reversed. So I asked your advise should I reduce my units of insulin intake by 5 units in morning and 5 units in night. I am not going to reduce the tablets Diamacron and Galvasmet.
Also my hegitht is 5.11 and my weight is 85 can you advise me what is BM proportion, and where I can get that chart in internet and I need this chart to bring the weight to normal as it is abnormal.
Thanks for your reply.
I will coonsult my diabetologist soon. But I am not fully convinced of your answer. This is not encoraging for a person who after all the health problem could reduce the sugar level which is true and asking for reducing the intake of insulin as one day with the current dosage it came to 70 by 12 noon and got sweat due to hypoglumacia and I had to rush to my home and take some sweets and it took hours to calm down. I felt the dosage of insulin is higher as I only increased it after readings were found higher. I had a history of severe back pain L4 L5 and I could not walk or stand in a place for a long time. Now that over 3 weeks I am able to walk in brisk way for 20mts say about 4 km in morning and in the evening. A patient like me, what is motivating? it is the will power to control and I found out it is getting controlled and it is getting reversed. So I asked your advise should I reduce my units of insulin intake by 5 units in morning and 5 units in night. I am not going to reduce the tablets Diamacron and Galvasmet.
Also my hegitht is 5.11 and my weight is 85 can you advise me what is BM proportion, and where I can get that chart in internet and I need this chart to bring the weight to normal as it is abnormal.
Brief Answer:
Self adjustment / treatment can be dangerous
Detailed Answer:
Most welcome , sir.
You have increased the dosage on your own. You can certainly reduce or alter the dosage by 2 units every time.
This is a bit safer way in Insulin dependent diabetic people. Yet I would request you to consult your Diabetologist.
Sorry to know about back pain at L4, L5. I hope you are under the Doctor's care and would have got investigated like MRI or so. Controlled diabetes will help to improve this pain too. IT is really great to know you are walking 4 km in the morning and evening.
Do not get me wrong . Everything suggested is for your betterment. This is a virtual talk so there may be chance of mis-understanding and mis-reading. Please read your questions and my answers - you had not given the full history in the first questions; how would I know about your requirements. Most of the patients are asked to consult the Diabetologist before altering the dosage as they have potential side effects like you had of hypoglycemia.
Please refer to this for BMI :::
http://bmicalculator.cc/?gclid=CjwKEAjwj4ugBRD1x4ST9YHplzMSJACTDms8E4aCWk1xob7RkQlruerJqGAvDLwaqj5GYQWqSmtIMBoCbrbw_wcB
Please feel free to ask for more if you need to.
Wishing you a great and healthy life.
Self adjustment / treatment can be dangerous
Detailed Answer:
Most welcome , sir.
You have increased the dosage on your own. You can certainly reduce or alter the dosage by 2 units every time.
This is a bit safer way in Insulin dependent diabetic people. Yet I would request you to consult your Diabetologist.
Sorry to know about back pain at L4, L5. I hope you are under the Doctor's care and would have got investigated like MRI or so. Controlled diabetes will help to improve this pain too. IT is really great to know you are walking 4 km in the morning and evening.
Do not get me wrong . Everything suggested is for your betterment. This is a virtual talk so there may be chance of mis-understanding and mis-reading. Please read your questions and my answers - you had not given the full history in the first questions; how would I know about your requirements. Most of the patients are asked to consult the Diabetologist before altering the dosage as they have potential side effects like you had of hypoglycemia.
Please refer to this for BMI :::
http://bmicalculator.cc/?gclid=CjwKEAjwj4ugBRD1x4ST9YHplzMSJACTDms8E4aCWk1xob7RkQlruerJqGAvDLwaqj5GYQWqSmtIMBoCbrbw_wcB
Please feel free to ask for more if you need to.
Wishing you a great and healthy life.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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