The fact that diabetes is disease that is characterized by high blood sugar is known to everyone as well as the fact that diabetes is treated by endocrinologists and the treatment means glucose level (glycemia) tests and monitoring this parameter by diets, tablets decreasing sugar level and finally by the insulin injections.

However doctors today consider that other medical specialists may also provide certain help to diabetics especially such doctors as psychologists and andrologists. As for endocrinologist they may considerably improve their work efficiency by establishing more friendly relations with their patients.

Psychological problems

Considering the fact that about 5-10% of people suffer of depression we should note that this number comes to the point of 33% among patients experiencing diabetes. Thus depression distribution among diabetes patients is quite more than its distribution among patients experiencing ischemia, oncological and skin diseases.

Due to researches it was revealed that diabetes patients most often experience nosogenic depression (this is a complex of negative thoughts concerning the disease itself).

- among second type diabetes patients often appears disthymia – that is prolonged depression characterized mainly by somato-vegetative symptoms resembling other diseases and not by the low spirits.

- among first type diabetes patients the most “popular” is the cyclothymia (that is a regular alternation of decadent conditions and elevated mood and boldness).

Furthermore, researches note that the last two types of the depression are quite similar to corresponding diabetes types according to their origins. Cyclothymia is quite often among teenagers and is concerned to genetical aptitude (as the first type diabetes). And the disthymia is caused by the negative impact of the environment and mainly appears in acme (as the second type of the diabetes).

No doubt that depression doesn’t help to treat the diabetes. Even the correct doctors’ recommendations will not provide the proper effect as this should be defined by the patients’ behavior also. Among all chronic disease the diabetes is the most complicated according to the number of the medical treatment that should be done on ones own. These are such procedures as diet, physical activity, glycemia monitoring, insulin therapy and many others. To do all mentioned above the patient needs not only time and means but a great enthusiasm as well.

Yet the patients having negative outlook concerning themselves and their future don’t follow the doctor’s prescription often in 3 times. As a result diabetes patients experiencing depression have worse glycemia monitoring numbers, higher cases of complications, higher mortality level as well as other sociomedical figures (disability, hospitalization period and etc).

What are the reasons of insufficient depression treatment? Here both patients (that are afraid of contacting psychiatrist) and doctors (commonly endocrinologists don’t consider psychological problems are worse of their attention) are guilty. However, light depression or medium depression treatment is in the endocrinologists’ competence. Especially this is true when we consider that they observe their patients for decades and thus they have more abilities to treat their patients as “individuals”. To define depression symptoms there is no need in complicated psychological tests. It is quite enough to ask patient whether he or she experiences low spirits for a prolonged time and whether he or she has lost an interest to something that was pleasant previously.

According to doctors it is quite possible to make an individual psychological portrait that may successfully get a compensation while diabetes. This are the people disposed to self-discipline and are easy to teach. However only a fourth of all people experiencing diabetes have these features. The other requires more serious work and individual approach in the psychotherapy area.

Erection problems in diabetes patients

Erectile dysfunction is one of the most wide spread complications of the diabetes. However patients often hesitate to contact doctor and suffer tacitly thus making their partners also suffering.

By the way erectile dysfunction may cause not only sex problems. Particularly, erectile dysfunction is an initial atherosclerosis sign. 57% of the men that have coronary artery shunting and 64% of those being hospitalized with cardiac infarction had experienced erectile dysfunction.

About 40% of all erectile dysfunction cases are among diabetes patients. And in case other men experience erectile dysfunction problems after 40 years old diabetics have it after 25 years old. And such problem in this age may cause serious psychological troubles. And it is slightly possible to treat diabetes without solving these problems.

Until recently there were no effective means to treat erectile dysfunction. Doctors were able to offer their patients only mechanic devices and intracavernous injections. Only in 1998 after the Viagra invention a new age in andrology has started. In 2002 another medication – Cialis and in 2003 – Levitra appeared. They are almost equal according to their efficiency; the only moment is that Cialis has 17 hours of partial ejection period (in other words it remains in the body for a longer period of time).

However the use of this medication in diabetes patients is less effective than in other men (only 68%). The matter is these medications modulate the natural erection and their action requires a libido that may be decreased in people suffering obesity or second diabetes type. Thus only Cialis use is not sufficient, as combined therapy with the use of male sexual hormones (androgens) is required. In this case the probability of erection recovery is about 80%.

Doctor and patient relations

Diabetes patients are prescribed quite complicated complex of sugar monitoring, blood fats, and arterial pressure procedures. Unfortunately not more than 20% of diabetics manage to maintain these figures in norm. In 9-10 years disease grow progressively worse in the most patients.

One of the important things in this concern is the doctors and patients relations. Endocrinologists that are quite experienced in theoretical questions are worse in practical matters like when insulin therapy should be started, how the patients should be taught of self-control and so on. Patients in their turn do not consider the health the main priority (62%) or simply are not aware of the parameters they should monitor initial aim (80%). And the organization of the doctors and patients communication in today health protection system only widens the gap between them. Irritated doctors intimidate patients with the insulin therapy and the irritated patients stop following doctors’ recommendations.

These barriers elimination is possible due to establishment of more friendly and partner relations between doctors and patients. It is known that friendly attitude of the doctor enables to increase the number of the patients reaching compensation by 20%.