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Diabetes is a common condition that affects both men and women and puts them at a greater risk for heart disease, stroke, kidney damage, vision loss, amputation of toe, leg or foot.
According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes estimates for about 90 to 95% of all diagnosed cases of diabetes in adults. The World Health Organization (WHO) reports that 90% of people around the world have type 2 diabetes.
In 2013, there were 14 million more men affected with diabetes than women  .
Can Diabetes Affect Male Fertility?
Diabetes has a harmful effect on fertility in men, according to a study published in the Human Reproduction Update  . Men who have pre-diabetes have a higher risk of sperm DNA damage, unexplained azoospermia (no sperm during ejaculation), and reduced testosterone levels.
How Does Diabetes Affect Male Sexuality?
Diabetes damages the blood vessels, nerves, and increases risk of infection, if uncontrolled. This results in an array of sexual problems in men including decreased sex drive, erectile dysfunction, ejaculation problems, and inflammation of the foreskin (balanitis).
Diabetes causes the following sexual health problems in men:
1. Erectile dysfunction
Erectile dysfunction is a common problem among middle-aged men and older men. According to the Centers for Disease Control and Prevention, men with diabetes are three times more likely to have erectile dysfunction. Increased levels of blood glucose, blood pressure, and cholesterol elevate the risk of erectile dysfunction  .
2. Reduction in sperm quality
According to a study published in the International Journal of Fertility, diabetes is linked to lowered sperm quality, sperm volume, and sperm motility  .
3. Retarded ejaculation
Diabetes can damage the nerves in the penis, as a result, there is a lack of nerve sensitivity which further affects the ability to ejaculate  .
4. Retrograde ejaculation
Diabetes also causes retrograde ejaculation which occurs when the nerves are unable to control the bladder muscles from the closing point of ejaculation, as a result, the semen enters the bladder rather than exiting the penis during orgasm  .
Retrograde ejaculation happens in diabetic males due to diabetic autonomic neuropathy (nerve damage).
-  Kautzky-Willer, A., Harreiter, J., & Pacini, G. (2016). Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus.Endocrine reviews,37(3), 278–316.
-  Maresch, C. C., Stute, D. C., Alves, M. G., Oliveira, P. F., de Kretser, D. M., & Linn, T. (2017). Diabetes-induced hyperglycemia impairs male reproductive function: a systematic review.Human Reproduction Update,24(1), 86-105.
-  Kouidrat, Y., Pizzol, D., Cosco, T., Thompson, T., Carnaghi, M., Bertoldo, A., ... & Veronese, N. (2017). High prevalence of erectile dysfunction in diabetes: a systematic review and meta‐analysis of 145 studies.Diabetic Medicine,34(9), 1185-1192.
-  Bartak, V. (1979). Sperm quality in adult diabetic men.International journal of fertility,24(4), 226-232.
-  Majzoub, A., Arafa, M., Al-Said, S., Dabbous, Z., Aboulsoud, S., Khalafalla, K., & Elbardisi, H. (2016). Premature ejaculation in type II diabetes mellitus patients: association with glycemic control.Translational andrology and urology,5(2), 248–254.
-  Kam, J., Tsang, V. H., & Chalasani, V. (2016). Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus.Urology case reports,10, 9–10.