Men's Health and Possibly TMI on Diabetes and Sex

Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.
This week, Wil takes on a sensitive question from a woman overseas who's asking on behalf of her husband with type 1 diabetes. The issue is what goes on in the bedroom, and how diabetes can play a part...
It's a real concern for many men, women and couples in our D-Community. Wil has some insight to share on this very touchy topic.
First Rule of Chronic Illness: never consult with Dr. Google. I can’t even count how many times I’ve scared the crap out of myself by Googling symptoms. OMG, my symptoms are an exact match! I have the nearly always-fatal Tasmanian Swamp Disease. Oh… Wait… It might be the always-fatal Bulgarian Mountain Sickness. Or maybe just a harmless, but annoying, case of Eastern Somali Ringworm. And that’s just the top three hits. There are 75 million more.
But seriously, Lani, I don’t think your guy needs any sort of medical doctor. I think he needs a marriage counselor.
Oh, and BTW dear readers, I wrote back to Lani and assured her there’s no such thing as TMI (Too Much Information) in my biz, and learned a few other pertinent facts that help illuminate today’s case study. Lani’s T1 was Dx’d at age 8, with typical control until the “screw-it” teen years when he had 2-3 bad episodes that landed him in the hospital. At age 19 his main squeeze Lani, our Down Under correspondent in this case, “fell pregnant.”
I love the way Aussies talk.
At this point, as a 19-year-old father, he cleaned up his diabetes management act. Lani tells me in the five years they’ve been together, he’s not had one trip to the hospital. She also reports—because I asked—that the sex “was fine” pre-baby, but “died off pretty significantly after our first.”  They now have a second child, as well. She says that sex over the last two years has been “very rare,” but that when it happens he’s never had any issues with getting and holding an erection. And lastly, she does concede that “stress management is not his talent.” 
So why am I so quick to rule out a biological cause the young Mate’s problem?
The Zebra Principle -- it's real, look it up. You can even ask Dr. Google.
Sorry about switching continents on you, but the Zebra Principle is a medical diagnostic theory that is summed up by saying that if you are walking through the woods in Wisconsin and hear hoof beats, it’s probably not a Zebra. Sure, it could be -- one might have escaped from the zoo. And Dr. Google would likely put that possibility higher up the food chain that it ought to be, but it’s just not too likely, given that zebras are not native to this region.
And in medicine you’re not too likely to get Tasmanian Swamp Disease unless you are in Tasmania, have visited Tasmania, or just fell pregnant by someone who is from Tasmania. Oh, and before you go check with Dr. Google, I totally made up Tasmanian Swamp Disease. But the long and the short of it is, the most likely cause is almost always the case. And just like hoof beats Down Under are unlikely to be zebras, so too are biological causes of this young man’s failed erection.
Let’s start with real-time blood sugar at the time of the failed cuddle-fest. Of course, blood sugar levels can affect male libido and function, but Lani and her mate ruled that out. She told us they checked his BG as part of their foreplay. OK, she didn’t word it quite that way…
Next, let’s think about biological ED. It’s a real and serious problem for male D-folks, but its much more likely in middle-aged men, not young bucks. As to some sort of penile neuropathy, I doubt it. Nerve damage takes time. From your description, I don’t think he spent enough time out-of-control to trigger it. The timing is also bad. While the sins of the past sometimes do come home to roost after long periods of good control, it’s rare. Neuropathy generally rears its ugly head during periods of bad control, or shortly following periods of bad control. It’s not too often you see it in folks who have had good management for five years running. And on top of that, I’d expect neuropathy to hit his feet before it hit his penis.
I think the zebras in the room are the babies next door.
A couple of weird things happen to men when they become fathers, and the younger the man the weirder it’s likely to be. Suddenly his favorite sex toy is a mother. OK. So that’s just… wrong! (At least to the young male brain.) Plus, his favorite sex toy’s best feature just morphed into a baby feeding station. Yuck.
And there’s more. Not only is his lady a new person, or a person with a new role, she probably pays more attention to the new upstart than to her man. And suddenly he has new responsibilities. All of this is stressful. Add to this the fact that babies wreak havoc on sleep schedules, social circles, planned activities, and the family bank account. Back in the day he just had to grab an insulin pen and a meter and he could hit the road. Now he needs a diaper bag that brands him as a new father, rather than as a potential bachelor stud.
Don’t get me wrong. Most men love being fathers. Or more correctly, most come to love their new roles. But it’s a lot to digest all at once. I didn’t check with Dr. Google, but I’d bet the number one cause of low sex drive in marriages is babies in the house.
Now, I know what are going to say, Lani, 'But he was really into it.' The babies were with grandma, etc, etc. Here’s a secret about the human brain: it’s actually several brains wrapped around each other like onion skins. The deepest, most primitive part of the brain controls heart rate, breathing, and the like. The top part is our thinking part. But guess what? The midbrain is where emotion happens. You can think you are relaxed, but if you inner brain is freaking out—kids, bills, kids, work, sleep, kids—it can highjack the whole body and shut down things like erections.
But all of that said, I think I’m more alarmed about the lack of sex volume in your relationship, than I am about one failed hard-on. I see the failed playdate as a symptom of a bigger disease, and one that has nothing to do with his diabetes. He’s let fatherhood and all it’s myriad of responsibilities get in the way of husbandhood.
And that’s what needs to be fixed.
I think this is one time when we could ask that quack, Dr. Google, for his opinion on who would be a good marriage counselor in your area. 

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