Early Signs of Diabetes in Men

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Early Signs of Diabetes in Men

Diabetes is a complex condition that can show up differently in men than it does in women.^1-3 More boys and men live with diabetes than girls and women. Out of the 3.1 million people living with either type 1 or type 2 diabetes in Canada, over 1.6 million are men.³ Knowing the early signs of diabetes in men and learning more about how to manage the condition can empower you to take the next steps on your health journey.

Are Men at Higher Risk of Developing Diabetes?

Men are more likely to be diagnosed with T1D, both in childhood and in adulthood.1 There isn’t a clear reason why this is the case, but some studies have shown that estrogen—which is more predominant in the female body—may play a role in preventing the development of diabetes.¹ While T1D is typically diagnosed in children, men over the age of 30 are more likely than women to develop Latent Autoimmune Diabetes in Adults (LADA) or “type 1.5” diabetes.⁴

Men are also more likely to be diagnosed with T2D at a lower weight than women. This is because men tend to store more fat around their bellies, which increases the risk of insulin resistance.³ Insulin resistance happens when the body isn’t as responsive to insulin, a hormone that sends signals to the cells in your body to absorb sugar, or glucose, for energy. If cells are less sensitive to insulin, they can’t absorb glucose from the bloodstream, leading to high blood sugar. When blood sugar levels are too high for too long, it can lead to the development of prediabetes and, eventually, T2D.⁵

The Influence of Sex and Gender on Diabetes

Across the gender spectrum, each individual has different biological factors that may influence the development of diabetes. The Canadian Institutes of Health Research define sex as the biological characteristics of a person, while gender refers to one’s social identity.⁶ Cisgender men (those whose gender identity corresponds with their biological sex) may experience diabetes differently than cisgender women. Among many other variables, sex-related factors like physiology and hormones can play a role in the development of both type 1 diabetes (T1D) and type 2 diabetes (T2D). In this post, to simplify matters, we use the term 'men' to refer to 'cisgender men.'

How Diabetes Develops

Understanding how the different types of diabetes work can give you insight into what’s going on in your body. Many factors contribute to the development of diabetes. T1D happens because an autoimmune event has destroyed the cells in the pancreas that make insulin. In T2D, a person may still have functioning pancreatic cells, but they may not be able to make enough insulin or effectively use the insulin they do have to absorb glucose for fuel.

There is no clear reason for the development of T1D. Genetics may determine whether a person develops T1D, but not all those who have the genes associated with T1D will develop the condition. Environmental factors like catching a virus can trigger the autoimmune response that destroys the cells that produce insulin. Diet and lifestyle do not play a role in the development of T1D.

On the other hand, T2D is influenced by a combination of factors that can include genetics and environmental circumstances as well as lifestyle. T2D develops over time as the body’s ability to manage glucose with insulin decreases. Individuals whose blood sugar is higher than normal, but not high enough to indicate diabetes are typically diagnosed with prediabetes, also known as borderline diabetes. You may be at greater risk of developing prediabetes and T2D if you:

Are over the age of 40
Have a parent, sibling, or child who is living with T2D
Have African, Arab, Hispanic, Indigenous, Asian, or South Asian heritage
Experience obesity or are overweight
Have a history of hypertension (high blood pressure)
Smoke regularly

What Are the Signs of Diabetes in Men?

It’s not always easy to know whether you are developing diabetes. Many people do not show noticeable symptoms right away. Because you may not experience the symptoms of diabetes, it’s important to talk to your doctor about getting regular testing if you have any of the risk factors. Diabetes Canada recommends that individuals over 40 get tested for diabetes every three years. Those who have risk factors for developing diabetes should be screened earlier. You can also check out the Canadian Diabetes Risk calculator to assess your risk of developing prediabetes or T2D.⁶

The symptoms of diabetes can develop slowly or, as is sometimes the case with T1D, show up quickly and lead to an emergency. Just a few of the first signs of diabetes in men can include:^8,9

Excessive thirst: Are you feeling more thirsty than usual and constantly reaching for water, unable to quench your thirst?
Frequent urination: Are you getting up multiple times a night to use the washroom, interrupting your sleep?
Erectile dysfunction: Do you have trouble getting or maintaining an erection?
Rapid fluctuations in weight: Have you noticed a sudden weight loss or gain without a significant change to your diet or exercise routine?
Extreme fatigue or lack of energy: Are you feeling persistently tired, even after a full night’s sleep?
Problems with vision: Is your vision blurry or hazy with frequent vision changes, dark areas or loss of vision? Do you see spots, dark strings (floaters), or flashes of light?
Frequent or recurring infections: Do you find yourself getting sick more often than usual or having repeated infections?
Slow healing cuts and bruises: Have you noticed that wounds, cuts, and bruises are taking unusually long to heal?
Pain or numbness in extremities: Do you have numbness, tingling, a burning feeling in your hands or feet?
Diabetic ketoacidosis (DKA): A severe sign of diabetes is diabetic ketoacidosis (DKA).7,8 It is life-threatening and requires immediate medical attention.

What is Diabetic ketoacidosis (DKA)?

DKA happens when the body can’t use glucose for energy and the liver turns fat into fuel instead, a process which produces acids called ketones. Having too many ketones in the bloodstream can be life-threatening, so it’s critical to get to the hospital and treat DKA immediately. Urinating frequently and being thirsty are early signs of DKA. Other noticeable symptoms can include rapid breathing, fruity breath, nausea, vomiting, and stomach pain.¹¹

Diabetes and Erectile Dysfunction

High glucose levels or high blood pressure can damage the blood vessels and nerves around the penis, resulting in erectile dysfunction (ED).² Men living with diabetes are three times more likely to experience ED, and it may be one of the first signs of diabetes. While it’s normal for erections to change while you age, ED happens when a man can’t get or keep an erection even if he wants to have sex.² Individuals who are at risk of diabetes and those living with prediabetes, T1D, or T2D can work with their doctor to monitor and manage their glucose levels to avoid high blood sugar, or hyperglycemia. This can reduce the risk of experiencing ED.²

Preventing or Managing Diabetes

Making regular appointments for check-ups can help you see where your glucose levels are at and can give you and your doctor the chance to come up with a blood glucose management plan. If you are at risk for T2D or are developing prediabetes, your doctor may recommend lifestyle changes that could include following a healthy diet, getting regular exercise, and managing your weight. Creating habits that support your health can help you lower your glucose levels and enhance your overall well-being. It can also potentially prevent the development of T2D.¹²

Glucose management is also important for those living with T1D or T2D. You can work with your doctor and diabetes care team to come up with a treatment plan that works for you. Those living with T1D will need to use insulin to keep their blood sugar levels stable.¹³ Many people living with T2D can treat diabetes with lifestyle changes, but your doctor may also recommend insulin and glucose control medications as treatment options.¹⁴

Managing your glucose levels can help prevent diabetes complications, including ED and DKA.^2,15 Your doctor will determine a target glucose range that will help you feel your best as often as possible. Keeping an eye on your glucose levels throughout the day can help you understand what affects them, empowering you to take action to stay in your target range. There are many factors that can affect your glucose levels beyond just diet and exercise. Sleep, stress, hormonal changes, and even external factors, like heat and cold, have an impact on your glucose. You can work with your doctor and diabetes care team to understand how to monitor your glucose levels and make the right treatment decisions in the moment.

Manage Your Glucose with Greater Confidence

It’s not always easy to tell what causes your glucose levels to go up or down. One of the best ways to get a clear view of what’s going on with your glucose is to use a continuous glucose monitoring (CGM) system to get your glucose readings. Dexcom CGM Systems have been proven to help reduce A1C and increase time in range.^16-20 With a Dexcom CGM, you can get continuous glucose readings that show you where your glucose has been, and where it’s going, in the palm of your hand without routine fingersticks.^*

Learn more about Dexcom CGM

* Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.

1 Ciarambino T, et al. Influence of Gender in Diabetes Mellitus and Its Complication. Int J Mol Sci. 2022;23(16):8850. Published 2022 Aug 9. doi:10.3390/ijms23168850
2 Diabetes and Men. Centers for Disease Control and Prevention. Reviewed March 15, 2022. Accessed December 6, 2023. https://www.cdc.gov/diabetes/library/features/diabetes-and-men.html
3 LeBlanc AG, et al. At-a-glance: Twenty years of diabetes surveillance using the Canadian Chronic Disease Surveillance System. Health Promot Chronic Dis Prev Can. 2019;39(11):306-309. doi:10.24095/hpcdp.39.11.03
4 Harding JL, et al. The Incidence of Adult-Onset Type 1 Diabetes: A Systematic Review From 32 Countries and Regions [published correction appears in Diabetes Care. 2023 Nov 1;46(11):2084]. Diabetes Care. 2022;45(4):994-1006. doi:10.2337/dc21-1752
5 Understanding Insulin Resistance. American Diabetes Association. Accessed December 6, 2023. https://www.diabetes.org/healthy-living/medication-treatments/insulin-resistance
6 Institute of Gender and Health, Canadian Institutes of Health Research. Strategic Plan 2018-2023: Science Is Better with Sex and Gender ” Canadian Institutes of Health Research. January 15, 2020. Accessed January 19, 2024. https://cihr-irsc.gc.ca/e/51310.html.
7 Ekoe JM, Goldenberg R, Katz P. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Screening for Diabetes in Adults. Can J Diabetes. 2018;42 Suppl 1:S16-S19. doi:10.1016/j.jcjd.2017.10.004
8 Type 1 symptoms. Diabetes Canada. Accessed December 6, 2023. https://www.diabetes.ca/en-CA/about-diabetes/type-1/symptoms
9 Type 2 symptoms. Diabetes Canada. Accessed December 6, 2023. https://www.diabetes.ca/en-CA/about-diabetes/type-2/symptoms
10 National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Eye Disease. Reviewed May 2017. Accessed January 19, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-
11 Diabetic Ketoacidosis. Centers for Disease Control and Prevention. Reviewed December 30, 2022. Accessed December 6, 2023. https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
12 Prebtani APH, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Reducing the Risk of Developing Diabetes. Can J Diabetes. 2018;42 Suppl 1:S20-S26. doi:10.1016/j.jcjd.2017.10.033
13 Type 1 diabetes. Diabetes Canada. Accessed December 6, 2023. https://www.diabetes.ca/about-diabetes/type-1
14 Type 2 treatment. Diabetes Canada. Accessed December 6, 2023. https://www.diabetes.ca/en-CA/about-diabetes/type-2/treatment
15 Complications of diabetes. Diabetes UK. Accessed December 6, 2023. https://www.diabetes.org.uk/guide-to-diabetes/complications
16 Beck RW, et al. JAMA. 2017;317(4):371-378.
17 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.
18 Martens T, et al. JAMA. 2021;325(22):2262-2272.
19 Laffel LM, et al. JAMA. 2020;323(23):2388-2396.
20 Welsh JB, et al. J Diabetes Sci Technol. 2022:19322968221099879.

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