Women with diabetes are at increased risk for sexual arousal disorder—that is, inadequate vaginal and clitoral swelling in response to sexual arousal. A small research study showed that in women with type 1 diabetes, sildenafil improved arousal, orgasm, and sexual enjoyment. A woman with diabetes should discuss problems of sexual arousal with her physician.
• The symptoms of diabetes depend upon the degree of insulin deficiency:
• If the insulin deficiency is modest so that the glucose levels are only slightly elevated, there may be no symptoms and diabetes may be discovered on routine testing.
• If the insulin deficiency is severe, there may be thirst, frequent urination, weight loss, tiredness, and blurred vision. If untreated there can be progression to diabetes ketoacidosis (in type 1 patients) or hyperosmolar coma (in type 2 patients).
• People who have poor glucose control over many years are at risk of developing long-term complications. These include:
• Untreated diabetic eye disease can lead to blindness.
• Neuropathy—peripheral neuropathy; autonomic neuropathy with resting fast heart rate and gastroparesis. Diabetic peripheral neuropathy increases the risk of foot injuries and infections. The nerve damage and circulatory problems of the penis can cause erectile dysfunction.
• Circulatory problems: heart disease, strokes, impaired blood flow to the legs.
• Treating blood glucose, lipids, and blood pressure can prevent the development and progression of these complications.
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