Chapter Three Watch Your Blood Sugar ED can also be an early indicator of diabetes, especially if you are under the age of 45. According to the National Institute of Diabetes and Digestive and Kidney Diseases, men with type 2 diabetes are two to three times more likely to develop erectile dysfunction. Here’s why: The poorly controlled blood sugar levels associated with diabetes can damage small blood vessels and nerves. The result can be impaired blood flow. Adding insult to injury, the majority of men with type 2 diabetes also have low testosterone levels. One of the biggest contributors to type 2 diabetes is food choice. Recent studies have clearly pointed to the fact that the biggest cause of obesity and type 2 diabetes is the excessive intake of carbohydrates and sugar. Your cells can’t use glucose without insulin, a hormone produced by the pancreas. Insulin helps the cells take in glucose and convert it to energy. When your diet is high in carbohydrates and sugar, over time you begin to dull the body’s sensitivity to insulin—a condition called insulin resistance. And it’s the first step toward full-blown diabetes. Insulin Resistance If you have insulin resistance, your muscle, fat, and liver cells don’t respond to insulin properly and can’t correctly absorb and use glucose from the bloodstream. This creates a demand for higher and higher amounts of insulin to literally shove glucose into the resistant cells. The pancreas tries to keep up with the demand by producing more insulin but with less effect. The result is that glucose levels go up in the bloodstream. Many people with insulin resistance have high levels of both blood glucose and insulin circulating in their blood at the same time. This dynamic has a highly damaging effect on all tissues and organs in the body. Even if you have insulin resistance, you don’t have to resign yourself to a future that includes diabetes. In 2001, the National Institutes of Health completed the Diabetes Prevention Program, a clinical trial designed to find the most effective ways of preventing type 2 diabetes in overweight people with insulin resistance. The researchers found that simple lifestyle changes reduced the risk of diabetes by 58 percent.