It would be advisable to see a doctor for further evaluation, if you experience one of these diabetes symptoms in men. Generally, retrograde ejaculation doesn’t need formal treatment unless fertility is a problem. Treatment options may include medications that help keep the bladder neck muscle closed during ejaculation – however these only work if the problem is caused by nerve damage, such as in diabetes.

Anyone can get type 2 diabetes. However, those at highest risk for the disease are those who are obese or overweight, people with family members who have type 2 diabetes and people who have metabolic syndrome (a cluster of problems that include high cholesterol, high triglycerides, low good 'HDL' cholesterol and a high bad 'LDL' cholesterol, and high blood pressure). In addition, older people are more susceptible to developing the disease since aging makes the body less tolerant of sugars.


A rapid-acting inhaled insulin (Afrezza) is also FDA-approved for use before meals. It must be used in combination with long-acting insulin in patients with type 1 diabetes and should not be used by those who smoke or have chronic lung disease. It comes as a single dose cartridge.Premixed insulin is also available for people who need to use more than one type of insulin. 

^ Nield L, Summerbell CD, Hooper L, Whittaker V, Moore H (July 2008). Nield L (ed.). "Dietary advice for the prevention of type 2 diabetes mellitus in adults". The Cochrane Database of Systematic Reviews (3): CD005102. doi:10.1002/14651858.CD005102.pub2. hdl:10149/92337. PMID 18646120. (Retracted, see doi:10.1002/14651858.cd005102.pub3. If this is an intentional citation to a retracted paper, please replace {{Retracted}} with {{Retracted|intentional=yes}}.)
Hemoglobin A1c or HbA1c is a protein on the surface of red blood cells. The HbA1c test is used to monitor blood sugar levels in people with type 1 and type 2 diabetes over time. Normal HbA1c levels are 6% or less. HbA1c levels can be affected by insulin use, fasting, glucose intake (oral or IV), or a combination of these and other factors. High hemoglobin A1c levels in the blood increases the risk of microvascular complications, for example, diabetic neuropathy, eye, and kidney disease.
In people with insulin resistance, the pancreas "sees" the blood glucose level rising. The pancreas responds by making extra insulin to maintain a normal blood sugar. Over time, the body's insulin resistance gets worse. In response the pancreas makes more and more insulin. Finally, the pancreas gets "exhausted". It cannot keep up with the demand for more and more insulin. It poops out. As a result, blood glucose levels start to rise.
Rates of diabetes are increasing worldwide. The International Diabetes Federation predicts that the number of people living with diabetes will to rise from 366 million in 2011 to 552 million by 2030. [63] In the United States, the prevalence of diagnosed diabetes has more than doubled in the last 3 decades, largely because of the increase in obesity.
A proper diet and exercise are the foundations of diabetic care,[23] with a greater amount of exercise yielding better results.[84] Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss.[85] Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[86] Resistance training is also useful and the combination of both types of exercise may be most effective.[86]
Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin resistance. When there isn't enough insulin or the insulin is not used as it should be, sugar (glucose) can't get into the body's cells to be used for fuel. When sugar builds up in the blood instead of going into cells, the body's cells are not able to function properly. Other problems associated with the build up of sugar in the blood include:
Skyler JS, Bergenstal R, Bonow RO, Buse J, Deedwania P, Gale EA, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol. 2009 Jan 20. 53(3):298-304. [Medline].
Mellbin LG, Malmberg K, Norhammar A, Wedel H, Ryden L. Prognostic implications of glucose-lowering treatment in patients with acute myocardial infarction and diabetes: experiences from an extended follow-up of the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 Study. Diabetologia. 2011 Jun. 54(6):1308-17. [Medline].
Type 2 diabetes is due to insufficient insulin production from beta cells in the setting of insulin resistance.[13] Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, occurs primarily within the muscles, liver, and fat tissue.[46] In the liver, insulin normally suppresses glucose release. However, in the setting of insulin resistance, the liver inappropriately releases glucose into the blood.[10] The proportion of insulin resistance versus beta cell dysfunction differs among individuals, with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin resistance and primarily a lack of insulin secretion.[13]
^ Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I (February 2010). "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials". Lancet. 375 (9716): 735–42. doi:10.1016/S0140-6736(09)61965-6. PMID 20167359.
The classic symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), and weight loss.[23] Other symptoms that are commonly present at diagnosis include a history of blurred vision, itchiness, peripheral neuropathy, recurrent vaginal infections, and fatigue.[13] Many people, however, have no symptoms during the first few years and are diagnosed on routine testing.[13] A small number of people with type 2 diabetes can develop a hyperosmolar hyperglycemic state (a condition of very high blood sugar associated with a decreased level of consciousness and low blood pressure).[13]
Two types of diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 CE with one type being associated with youth and another type with being overweight.[111] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination.[111] Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922.[111] This was followed by the development of the long-acting insulin NPH in the 1940s.[111]
People with diabetes are at greater risk for kidney disease over time. A nephrologist is a doctor that specializes in the treatment of kidney disease. Your primary care doctor can do the yearly test recommended to identify kidney disease as soon as possible, but they may refer you to a nephrologist as needed. The nephrologist can help you manage kidney disease. They can also administer dialysis, treatment that is required when your kidneys aren’t functioning properly.
Regardless, check with your doctor and get tested. If you discover that you do have prediabetes, remember that it doesn’t mean you’ll develop type 2, particularly if you follow a treatment plan and a diet and exercise routine. Even small changes can have a huge impact on managing this disease or preventing it all together—so get to a doctor today and get tested.
Maturity onset diabetes of the young (MODY) is a rare autosomal dominant inherited form of diabetes, due to one of several single-gene mutations causing defects in insulin production.[55] It is significantly less common than the three main types, constituting 1-2% of all cases. The name of this disease refers to early hypotheses as to its nature. Being due to a defective gene, this disease varies in age at presentation and in severity according to the specific gene defect; thus there are at least 13 subtypes of MODY. People with MODY often can control it without using insulin.[56]
A British study indicated that the HbA1c level achieved 3 months after the initial diagnosis of type 2 diabetes mellitus predicts subsequent mortality. In other words, according to the report, aggressive lowering of glucose after diagnosis bodes well for long-term survival. (Intensified diabetes control must be introduced gradually in newly diagnosed patients.) [75] 

Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period.[10] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2]
^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
Accumulating evidence suggests that depression is a significant risk factor for developing type 2 diabetes. Pan et al found that the relative risk was 1.17 in women with depressed mood and 1.25 in women using antidepressants. [56] Antidepressant use may be a marker of more severe, chronic, or recurrent depression, or antidepressant use itself may increase diabetes risk, possibly by altering glucose homeostasis or promoting weight gain.
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 AD with type 1 associated with youth and type 2 with being overweight.[114] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus which is also associated with frequent urination.[114] Effective treatment was not developed until the early part of the 20th century when the Canadians Frederick Banting and Charles Best discovered insulin in 1921 and 1922.[114] This was followed by the development of the long acting NPH insulin in the 1940s.[114]

^ Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, Accurso A, Frassetto L, Gower BA, McFarlane SI, Nielsen JV, Krarup T, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti HM, Wood RJ, Wortman J, Worm N (January 2015). "Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base". Nutrition. 31 (1): 1–13. doi:10.1016/j.nut.2014.06.011. PMID 25287761. 

It would be advisable to see a doctor for further evaluation, if you experience one of these diabetes symptoms in men. Generally, retrograde ejaculation doesn’t need formal treatment unless fertility is a problem. Treatment options may include medications that help keep the bladder neck muscle closed during ejaculation – however these only work if the problem is caused by nerve damage, such as in diabetes.
A second oral agent of another class or insulin may be added if metformin is not sufficient after three months.[80] Other classes of medications include: sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analogs.[80] As of 2015 there was no significant difference between these agents.[80] A 2018 review found that SGLT2 inhibitors may be better than glucagon-like peptide-1 analogs or dipeptidyl peptidase-4 inhibitors.[96]
Susceptibility to type 2 diabetes may also be affected by genetic variants involving incretin hormones, which are released from endocrine cells in the gut and stimulate insulin secretion in response to digestion of food. For example, reduced beta-cell function has been associated with a variant in the gene that codes for the receptor of gastric inhibitory polypeptide (GIPR). [23]
Don’t worry. The first thing you should do if you have these symptoms is to make an appointment to see your doctor. He or she may suggest that you get a screening test done. This is a simple blood test (fasting blood glucose, or HbA1c) that can tell you if you’re likely to have diabetes. Your doctor will also do a thorough check to look for other causes of your symptoms, and refer you to a urologist for further evaluation if needed.
[Guideline] USPSTF. Public comment on draft recommendation statement and draft evidence review: screening for abnormal glucose and type 2 diabetes mellitus. US Preventive Services Task Force. Available at http://www.uspreventiveservicestaskforce.org/Announcements/News/Item/public-comment-on-draft-recommendation-statement-and-draft-evidence-review-screening-for-abnormal-glucose-and-type-2-diabetes-mellitus. Accessed: Oct 14 2014.
For type 2 diabetes mellitus to occur, both insulin resistance and inadequate insulin secretion must exist. For example, all overweight individuals have insulin resistance, but diabetes develops only in those who cannot increase insulin secretion sufficiently to compensate for their insulin resistance. Their insulin concentrations may be high, yet inappropriately low for the level of glycemia.
×