March 15, 2026

Type 2 Diabetes and Erectile Dysfunction: The Warning Sign Men Over 40 Don't Want to Talk About - 91

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Season 1Labs & Health

Today Coach Brian goes deep on a symptom most men experience and almost none ever bring up with their doctor when it comes to type 2 diabetes.


This is not a surface-level conversation. Brian breaks down the three separate mechanisms driving erectile dysfunction in men with type 2 diabetes or insulin resistance, and why understanding the difference between them changes everything about treatment and recovery.


You will also learn why the standard medication backup plan works for roughly half the men in this situation, what most doctors never have time to explain about sleep, testosterone, and blood sugar, and why a specific number on your waist measurement is one of the most direct hormonal levers available to you without a prescription.


For business owners and entrepreneurs who rely on mental sharpness, physical energy, and stress management to perform at a high level, unmanaged blood sugar affects far more than the body. It affects productivity, focus, decision-making, and how present you are at home and at work.


This episode gives you the full picture, a 30 to 90 day expectation framework, and five action steps mapped directly to the mechanisms driving the problem.


What this episode covers:

• Why erectile dysfunction often shows up before a type 2 diabetes diagnosis and what that timing means for your cardiovascular health

• The three mechanisms driving this condition in diabetic men: vascular, neurogenic, and the anxiety loop that makes both worse

• Why PDE5 inhibitors work for roughly 50 to 60 percent of diabetic men compared to 80 to 85 percent in the general population

• The undiagnosed sleep condition affecting up to 70 percent of men with type 2 diabetes and how it suppresses testosterone overnight

• The waist circumference threshold linked to aromatase conversion and what dropping below it does to free testosterone

• The three to five year cardiovascular window tied to this symptom when the underlying metabolic dysfunction goes unaddressed

• How to read your testosterone panel results, including what free testosterone and SHBG numbers actually mean for men in their 40s

• What to expect at 30, 60, and 90 days when the right habits are in place

• The conversation most married men avoid having at home and why having it breaks the biochemical anxiety loop directly

• Five action steps tied to each mechanism so you know exactly what to do and why



Free resource: Grab the Improve Your Blood Panels Scorecard and the 3-Day Metabolic Reset Protocol at This breaks down blood work in plain language.

A1c, cholesterol, blood pressure, and what affects them.


Here’s the scorecard you asked for.

https://brianparana.short.gy/improveyourbloodpanels



Built for men whose labs are trending the wrong direction and who want a structured starting point.

Book a private lab review at brianparana.short.gy/privatelab

Want help applying this to your own health, weight, energy, or lab numbers?

Coach Brian Parana offers Health Hot Seat coaching segments for men who want a clear next step with nutrition, fitness, weight loss, blood pressure, cholesterol, A1C, or daily consistency.

Learn more about The Call To Rise, a 100-day coaching program for driven men over 40 who want to lose weight, improve their health, and rebuild confidence:

www.thecalltorise.com

To connect with Coach Brian:
brian@brianparana.com

Disclaimer: This podcast is for education and coaching support only. It is not medical advice. Always work with your physician before changing medication, treatment, or medical care.

  • More than half of men with type 2 diabetes will experience erectile dysfunction. Most never bring it up with their doctors or even their wife, and almost none of them know it is a warning sign for cardiovascular disease. Cardiologists have known for years that the smallest arteries fail first. Most men think that it's a bedroom problem, but find out the hard way later when they get diagnosed with type 2 diabetes.
  • If something has changed in the bedroom and your doctor does not know about it, you are in the majority of men who say nothing about it at all. They play it off as stress, alcohol, not enough sleep, a brutal stretch at work, and then they just move on. What they do not know is that this symptom is one of the most critically significant early signs in men's metabolic health because of what it is lying underneath.
  • I'm Coach Brian Piranha. This is Driven for Health, episode 91. I've spent the last 23 years coaching men through all sorts of different health problems that do not have a clear road map, especially when it comes to diabetes or weight loss or other chronic illnesses. This is a continuation of episode 89 of I just got diagnosed with type two diabetes. Now what? That's the title.
  • So you can go back and listen to that episode to go through the full plethora of not knowing what it is to actually starting to feel signed symptoms. Something that sends you to the doctor, you get the diagnosis, the high A1C, you're in the doctor's office, and then what happens after I go through all those different scenarios and lay it out in very specifics.
  • You also get a walk away blueprint on what to do the next 90 days from that situation. Today, we're going deep and diving with the full mechanics of type 2 diabetes, the research, three pieces of information in this episode that your doctor probably hasn't told you about unfortunately in the 15 minutes that they get to spend time with you.
  • The number that reframes everything and that's between 50 to 75% of men with type 2 diabetes will develop erectile dysfunction. That is the majority of men living with this disease. All right, that's 50% to 75%. That's big. Think about that. Pause. If you have type two diabetes, this is almost a it's definitely a flip of a coin that it might be you.
  • Now, consider this. In many of these cases with men, the ED shows up before the diabetes diagnosis does, before the A1C comes back elevated. Sometimes two to five years before a doctor even says a word about diabetes. For a significant number of men, this symptom is not a consequence of the disease.
  • It is just the first sign of underlying systems that are already starting to break down. The body is sending you warnings, red flags, long before your A1C actually goes up. I'll hear it so many times. A guy will come to me, they're 230 lb, 250, 280. All my blabs are fine. Now they are, but in a couple months or a couple years, they most definitely will not be overweight and obesity is a direct correlation with lining up with type 2 diabetes.
  • Now, also, just so you know, you can have type two diabetes and not be overweight. You can be at a healthy body weight, but it's your nutritional behavior patterns that really start showing up and are the cause of that of eating just simple carbohydrates, lots of sugary beverages, and and not having a lot of protein or fibrous foods that over a long time can raise your A1C, your fasting blood glucose levels, and ultimately get you labeled with type 2 diabetes.
  • Here are three mechanisms why this is more complicated than you think. Most conversations on this topic treat erectile dysfunction and diabetic man men as one problem with one cause. That framing is why most guys end up staying stuck, confused, and unsure about is this even an issue for you to have to deal with.
  • Three separate mechanisms drive this. They can run independently separate of each other but then they can compound on each other as well. Which one or which combination you are dealing with changes what recovery actually look like. Let's go through these. Mechanism number one is the blood flow problem. When blood sugars stay elevated over months and years, again, whether you're overweight or not, you can have elevated blood sugar levels based on the foods that you eat, the times that you eat it, and whether you have any protein and fiber as well. The elevated blood sugar
  • levels damage your inner lining of your blood vessels. This is called your endothelium. Now, its job also includes producing nitric oxide, the compound that signals blood vessels to relax and open so blood moves freely. When the endothelium takes damage and is worn down, the nitric oxide production drops.
  • Vessels don't dilate, they restrict. They start to decrease blood flow throughout the body. the and here's a simple analogy. A garden hose. Picture a garden hose with material building up slowly coating the inside the narrow section of that hose shows to be the first problem first. Just like any of your blood vessels or think of having a arterial sclerosis with high cholesterol that becomes a big issue for a lot of guys and that's where the site of the heart attack or stroke may often lie. Now pressure drops at the
  • far end of the the hose. So let's go back to the hose. You have say 25 ft and in the first 5 ft in you have a narrowing then pressure is going to drop significantly by 25 ft out. Okay, this is a big problem that you notice because of the narrowing. The narrow section is the big problem with the buildup.
  • Now the arteries involved in sexual function are roughly one to two millimeters across. Tiny like this big. Real tiny. If you see in the video it's a a millimeter is is very very small. The arteries supply your heart run three to four millimeters. Okay. So basically three to four times larger. the small vessels, blood vessels will fail first and because the problem will get worse there and that's where the pipe is narrow.
  • So even if say you have some blockage at other parts of your body, your your your manhood there is going to end up being smaller because it's at the end of the road, right? It's at the 25 foot mark of the hose. Cardiologists call this the artery size hypothesis. In 2018, a meta analysis put a number of of on on the connection of men with erectile dysfunction and no other cardiac symptoms can carry 44% more risk of a future cardiovascular disease or event compared to men without it.
  • Right? So 44% of men with ED can potentially be at risk for higher cardiovascular issues in the future. So I had to say that again. The narrow section of the hose is showing you a problem that exists throughout the whole system and the loss of flow or pressure at the end of the road as say the ED is where it's starting to show up.
  • Mechanism number two, the signal problem. An erection does not start with blood flow. It starts with a nerve signal. Your autonomic nervous system runs all things just unconsciously. Yeah, you don't have to actually think about it. This is stuff the heart rate, your digestion, your breathing. It also initiates and maintains sexual function.
  • High blood sugar sustained over a long time damages these autonomic nerve pathways. This is called autonomic neuropathy. It is also common in diabetic men than most people realize. So you have to think if again if you're diabetic you're experiencing neuropathy at a higher rate or higher risk of doing that.
  • Reason is the standard medication backup plan for this is not reliable. Let's jump in the light switch analogy in the wiring to help explain this. Picture a light that flickers when you flip the switch. The bulb is fine because it just flickered on and off, but full power is coming to the house, but the wiring between the switch and the fixture has been damaged somehow.
  • insulation is worn off and it's worn away somewhere in the wall. You can have everything working and the light still doesn't work. I have that I'm dealing with that problem right now with my hot tub. There's a small nick in the wire, which means that the insulation has failed.
  • And now the outlets that are on this side of my hot tub do not work. And I have to replace the wiring from the actual connection, replace the the broken part, and I can't just tape it up. That's not how that works. I have to actually repair and replace the wire itself. this neurot neurogenic erectile dysfunction. That's what this is.
  • Blood flow may be adequate and fine, but and your hormones may be fine too, but the problem is the nerve pathway carrying the in the initial signal to get you excited and and ready to have some fun is compromised by years of elevated glue blood glucose levels eating away at the protective coating around these nerves.
  • This mechanism responds differently to different treatments. Vascular function can start improving within weeks of lifestyle changes like eating healthier foods and more balanced meals and getting away from just sugar and high carbohydrate meals. Nerve regeneration is measured in months to years. Unfortunately, that takes an incredibly long amount of time to regenerate under especially underneath controlled blood sugars.
  • That's not to discourage you if this might be one of the mechanisms causing you challenge. It is said because men who understand that nerve damage compounds over time and has a reason to you got to act now if you want to think about blood flow down the line years later. The third mechanism, the anxiety loop, unfailed or inconsistent episode creates performance anxiety, right? You're going for gold, right? And then there's a misfire in a sense and performance anxiety flares up your stress response. Your stress response
  • releases cortisol. Cortisol directly raises blood sugar levels. High blood sugar worsens the endothelial function and the nerve signaling. So instead of vasoddilating getting bigger, it restricts. Right? We talked about that earlier. And now we have a failure problem. Right? the blood flow isn't there. In a man without metabolic dysfunction, this loop usually breaks on its own.
  • One good experience interrupts it and you're you're back on track. You're good. Now, in a man with insulin resistance or diabetes, and insulin resistance can show up for years before being diagnosed with diabetes. That cortisol spike runs straight through the blood sugar feeds this mechanism of basil constricting and and you're already working against yourself.
  • The anxiety doesn't just sit in his head. It it stays there and it continues to build. So every time you're ready to roll, then we have this big mental but actual physiological issue boundary wall that you have to overdo. Now this is the compounding struggles that you end up. The man who thinks that he's failing personally with not being able to maintain is trying to solve the wrong problem.
  • And the the problem is a loop running throughout the circuit breaker. It cannot be fixed by relaxing more and the interruption has happened at a metabolic level and it has to actually get resolved in another way. I want to name something. If you have not said it out loud or thought about it out loud to enough to share, you've explained this away enough times that the explanations are really just weak at this point.
  • It's like, "Oh, I'm just stressed out." Something's actually off. And you know it that you can feel it on the underneath inside. And for whatever reason you gave yourself this week, there's one thought running through your mind. What if this is just who I am now? That's a thought like, "Ah, just I have ED.
  • " And this is a big challenge for guys because it affects your confidence, your performance in multiple different areas, especially comes with sexual behaviors. That thought is what's keeping men from taking action to actually go find a solution, go have a conversation with a proper doctor. And there's still room to resolve this.
  • And you should be starting to question what's going on and get away from your internal conversation and then move into actual real solutions. The cost of this silence is clinical and it's challenged you on multiple different levels from every week without the right information in front of the right doctor is a week where you're possibly even getting worse.
  • ultimate cost is grows. It mounts. It compounds over time. As we said, we can metabolically heal you within a week or a couple weeks. But with the actual the um the the actual say nerve that is long months or years in a sense. So what's happening is your testosterone, the visceral fat around your belly, uh behind your belly, around your organs, your abdomen, that that hard fat that's stored there contains an enzyme called aromatase.
  • And aromatase converts testosterone into estrogen. The more visceral fat you carry, the more your own testosterone gets converted before it even reaches the tissue that it needs to. So, you're you're kind of shooting yourself in the foot because if you're overweight, your testosterone is way more likely to turn into estrogen, which is causing a challenge with sex hormones.
  • At the same time, insulin resistance disrupts a protein called sex hormone binding globulin. It's SH EG. So, this controls how much free testosterone circulates in your blood. When that balances off, free testosterone drops even when your total testosterone looks okay on paper. This is why men get blood work back showing normal ranges of testosterone are still not feeling like themselves.
  • Research puts the waist circumference threshold around 40 in for most men. Okay, if you have 40inch waist, you have a lot of visceral fat and that is a big issue for you. Okay, guys over 40 ines are incredibly more likely to have heart disease, type two diabetes, high cholesterol, high blood pressure, be on meds, shorten their lifespan.
  • An average male's life is 76. That's a big problem if you're in your 40s and 50s, the guys listening to this. Now above that number the aromatase activity is elevated enough to suppress free testosterone. Now below it that conversation is slows because there's specific trackable numbers and it is one of the most direct hormonal levers available to you without a prescription.
  • Low testosterone reduces libido. It reduces morning erections. It disrupts sleep quality and makes it harder to build the muscle that keeps insulin sensitivity higher. If you have more muscle on your body, you can manage blood sugar levels better, manage insulin a lot better, and manage carbohydrate loading into muscle glycogen into your muscles.
  • And this will lower visceral fat and then it will help you keep your testosterone levels higher if we can keep that muscle up. One loop multiple entry points. So we have a lot of things to address here in this situation. The diagnosis most men in this room have never been offered. This is a section most podcasts on men's metabolic health skip entirely.
  • We shouldn't skip it. We should talk about it. Men between 40 and 50 with metabolic syndrome, carrying visceral fat, running elevated blood sugar, sleeping poorly, having low amounts of body lean body mass muscle on their body, disproportant higher rates of undiagnosed obstructed sleep apnnea. This research estimates that it puts at 50 to 70% of men with type 2 diabetes have clinically significant sleep apnnea.
  • All right, that's a problem for you. Okay, we do not want sleep apnnea to be affected and hurt you or challenge you or uh cause big long-term issues. Now when men are in their 40s and 50s and they're they have metabolic syndrome carrying this visceral fat this is and that obstructed sleep apnnea. What happens is the airway partially or fully collapses during sleep, pulling you out of deep sleep repeatedly throughout the night without you actually even being awake.
  • So, you're just in and out of this twilight phase in a sense. And your your bed partner probably knows they hear you snoring or you're gasping for air, you're wheezing or you just stop breathing. All these things are really big challenges for just even just sexual attraction, right? Like, oh, my partner snores a lot loudly and keeps me up, so I don't actually get sleep. So, that's a big problem.
  • Now, you wake up in the morning and you barely feel like you slept and you're definitely not rested even though you've been in the bed for hours. Testosterone production in men happens predominantly in deep sleep. So here's the issue is that if you're not getting deep sleep, then you are not getting a lot of testosterone production handled.
  • If you're cycling in and out of deep sleep 20 to 40 times an hour because your airway is collapsing, your body is not getting into the deep REM, the repair cycles that it needs to help with hormonal balance overnight. Sleep apnoa also drives cortisol elevation. We talked about cortisol, right? It it challenges your blood vessels and your ability to keep basil dilated.
  • It worsens overnight glucose control because cortisol can spike blood sugar levels and it is one of a a very treatable condition in a clinical picture. Let's say a sleep study which you can get from your primary care doctor in order takes one night and then CPAT treatment can help which certainly feels awkward and it's not romantic in the least bit but if you can get more quality sleep and get your health in order then this can be an immediate solution for you to be able to start changing your ways changing your health and getting back to normal life.
  • When we get the CPAP treatment going on for obstructed airway, this can help you sleep in longer deep REM sleep, allowing your testosterone to improve, allowing you to ideally get away from sleep apnoa, dealing with low testosterone and get back to normal, healthier life. If you do snore, guys, you wake up unrested, regardless of hours slept and you crash in the afternoon, ask for a sleep study. Okay, please do that.
  • You will learn quite a bit about your behaviors around sleep. And this could be a really simple, high lever test where you can start to get some rest, to have some energy, to go to the gym, to take better care of yourself. all all those things. The signal you can track yourself. Okay, this is what we want to pay attention to.
  • Healthy men experience three to five erections during sleep as part of a normal physiological repair cycle. The body produces this process to oxygenate tissues during REM sleep. So, it'll send blood through all your tissues and you'll get an erection. Doctors use the presence or the absence of nocturnal erections as a diagnosis tool when this when when we're going through some of these issues with the veins and your your vas vascular system and you're damaged then we don't have this. The presence is there.
  • there's just no erection at all or it's very small or maybe disproportionate in the number of times or you might not have it at all during the day which is then you would notice it a lot more. There are early measurable signs for this to start to see when was the last time you had a morning wood, when was the last time there was just some excitement down in the pants at any time.
  • And if you don't have those, then you need to go address this. If the frequency and reliability of of the morning wood has declined over the past year or five, that is enough data for you to go talk about it at your next appointment so that your doctor knows and start to prescribe the next best step. not necessarily medicine, but the next step for you to resolve this.
  • And yes, it's embarrassing to have to say this, but it's reality of an aging male. And if you're in poor health, then it will be even more uh of an issue. The medication truth that nobody leads with. This is a challenge because a lot of medication is the first thing especially with big pharma and everything going on and doctor's small amount of time availability with you.
  • Many men in this situation have a backup plan if things get worse their medications. Most people know brand names and the plan is to handle with a prescription when it comes to that. In the general population, PDE5 inhibitors, this is a drug class that these medications belong to work about 80 to 85% of the men who take them.
  • In men with diabetes related erectile dysfunction, that number drops to 50 to 60. So more it's more of a flip of a coin rather than more of a roll of the dice that it's going to work on you. So again, if you have type two diabetes, a medicine might not be the answer. The reason comes back to simple mechanisms. These medications work by enhancing nitric oxide signaling and increasing blood flow.
  • They address the vascular problem, but they don't address the neurogenetic issues, the the nerves and the slow recovering of that due to elevated blood sugar levels for years. and the damage. If you have a nerve damage issue, then it ends up being a long-term problem for you because it's going to take forever to fix if especially if you're not very diligent about your nutrition, activity, and all and your overall well-being.
  • Now, the initial signal is impaired regardless of how much blood flow improves with a say a medication. Better plumbing does not fix damaged wiring. The medications cannot address what nerve damage has caused. So that's a big issue here. If your your your your blood vessels are flowing but the nerves don't kick in, then yeah, you'll you'll have big issues.
  • and the backup plan that most guys are thinking about that works for him like I'll just take Viagra or something but again it it might not work. That's what we're talking about in this portion of our conversation. So next up is the 3 to five year window you need to understand. So what what do we start doing to think about this? Well, researchers tracking men with erectile dysfunction and no other known cardiovascular symptoms found that there's a meaningful percentage experience a documented cardiovascular event within 3 to five years when their
  • underlying metabolic dysfunction was not addressed. So, if you have a metabolic disease and you didn't deal with it, there might be a big cardiovascular event headed your way in the next couple years. I don't know about you, but nobody listening to this podcast or watching right now in the live feed wants to have a cardiovascular event, right? That's not it.
  • Now this data comes from multiple largecale longitudinal studies meaning that they studied a followed men over a long time and including analysis drawing from the Princeton consensus cardiovascular risk guidelines three to five years for most men that is pretty quick. That is before your youngest finishes high school, before your business gets to where you're building it toward.
  • Before you are ready for any of these lifech changing experiences to happen and life-changing experience in a bad way. Nobody wants a heart attack or stroke or even ED symptom shows up now is not predicting something that might happen in older age. It is a measurable signal about a window that is happening in the near future.
  • So we can't push this off to oh when I'm 70 I'll have a heart attack. No, when you're 45 or 50 you'll have a heart attack. This information should change whether you actually make an appointment here in the next week or two or you just keep putting it off. So think about that. The wrap up on this section is that in three to five years if you have insulin resistance, type two diabetes, uh you are experiencing these issues around erectile dysfunction, you literally know your body feels off.
  • There might be a bigger issue coming in your near future. We do not want that. Okay? Definitely don't want that. How do we have real conversations at home? This also gets skipped as well and we want to pay attention to that. If you're married and or have a partner and your wife already knows something's different, she would know.
  • she's been around you and neither of you actually put a finger on it or named it. It's just uncomfortable things not happening in the bedroom or there's just an absence of things happening in the bedroom. Then we need to talk about the longer that you don't talk about it with your spouse, the more she might think there's something wrong with her or or whatever.
  • This silence of not having actual real conversation with your partner will create a big gap in your marriage and it'll compound longer and faster than you want it to. And it it it's going to be a big challenge to overcome. And it's going to be multiple conversations later if you don't have it earlier. And you don't have to have it.
  • It doesn't have to be this long clinical type conversation. And it could be something that's a one sentence, something like some something has been going on with my health that I'm working on. There's nothing to do with you and I did not want you left trying to figure out what was going on. Like, hey, you just admit it's okay to admit and be open and have a real conversation.
  • Hey, I don't quite feel the same like I have in the past. I want to work on getting better health and this is some of the challenges that I've been experiencing lately and thinking through this. Now when you can put that on in your relationship be open that actually can create better connection and create a solution a teamwork type solution so that you can help manage this and get your health back on track.
  • One thing we want to talk about like the structural cost of waiting. Well, what are the challenges of just waiting here? When blood flow to the relevant tissue is chronically reduced over time, the smooth muscle tissue involved in an erection begins to change at a cellular level.
  • Collagen deposits replace elastic fibers. The tissue loss is responsive. It's called fibrosis. Here's an analogy for it. The rubber band analogy. Pull a rubber band out of a fresh bag. It stretches. It snap back and let's also find one that's been sitting in the drawer for five years. It still looks like a rubber band. You pull it and and but the give is gone and it doesn't stretch and you might start to tear.
  • See cracks in the rubber. The rubber band in the drawer has say in quotations is has not been getting good blood flow. The time the oxygen has deprived the material itself and cause it to break down. vascular dysfunction. The muscular dysfunction is what puts that rubber band in the drawer to uh to crack and break and not be a rubber band anymore, whereas a fresh one is.
  • And that's what's happening to your your manhood over time is if we're not using it, we lose it. And your body doesn't know how to function properly. We don't aren't able to restore blood flow early enough. and and the materials can be recovered and and so fibrosis sets in and this is that oxygend deprived situation that will cause permanent changes down there.
  • Lifestyle intervention can improve blood vessel function with sustained blood sugar control. It can support nerve regeneration over time. Structured fibrosis is structural fibrosis does not reverse through lifestyle changes though the window to act does not close because you got older.
  • It closes because the tissues change and how long it takes depends entirely on how long this dysfunction has gone unressed. Same thing say with weight loss. If you have gained 50 pounds, we're not going to lose 50 pounds and maybe you can lose in five months. Like that's 10 pounds a month. That's that's really good. But you spent years growing it and these habits and these behaviors and all these things.
  • This is real life. And so we need to make sure that we get the changes that we need to be able to undo it and just have the proper expectations that it might take a little bit longer than you want it to. Here's some action steps to help with the mechanisms that we talked about. These are specific actions for the mechanism.
  • So for the vesticular uh sorry the vascular mechanism walk after dinner get your heart rate up above zone 2 which would be say 120 130 or more. Uh by moving your body and getting that blood flow it helps improve nitric oxide production and glucose disposal. meaning it just it it will use up or properly shuttle glucose where it's supposed to.
  • The vascular mechanism is the most responsive life change that you can make. So moving your body frequently throughout the day instead of just sleeping when you do and sitting the rest of your life, we can start doing that now for their neurogenetic mechanism. The nerves get your blood sugar levels under control. It should be maybe 100 fasting in the morning.
  • It should not really go over 150 because you're not eating too many calories or too many carbohydrates or sugars at any one time. Now, nerve regeneration is requires a consistent glucose environment over time, meaning you have to manage it and we have we have to have a a very long time of doing this. The 90-day average, your A1C measures is the number that creates the biological conditions for nerve repair.
  • So if your A1C is going down and it is in a healthier range, then that can mean that your likeliness to improve your nerve regeneration is a lot bigger. for the the psychological loop. Say something to your wife, have that actual real conversation, get to the doctor, and start looking at ways to reduce cortisol load in your life, in your body, and manage a feedback loop of anxiety around performance.
  • And you cannot exercise or supplement your way out of this one. Okay, this is something that has to be managed through literally decreasing stress in your life for the testosterone and amotase aromatase, excuse me. Get your waist under 40 inches. Okay? You can't have visceral body fat hanging out in your midsection around your organs.
  • You will die earlier than you want to. It's not even just about losing weight. It ends up being about just living longer at a higher quality life, having energy to be able to do all that stuff. For sleep and hormonal repair, get a sleep study. If you're snoring, if you wake up feeling unrested, if you are dying for a nap in the middle of the day, figure that out.
  • Ask a doctor, get a sleep study, and if you need a CPAP, then do it. It's not exciting, but it can help to be the immediate solution for right now to help start improving your overall health and quality of life. What do we expect in the next 30, 60, 90 days from actually doing these things? At 30 days, if you're walking after meals, your blood sugar levels are improving and your fasting glucose are moving in the right direction down to 100 or so.
  • You have consistent energy throughout the day. The the morning wood comes back and starts to show improvements and oxid nitric oxide production responds to regular postmeal movement, then we're moving in the right direction. Okay, at 60 days if visceral fat is dropping and sleep is actually you pay attention to how much time you're sleeping and how quality and maybe have a a watch or a ring that you can wear to help monitor sleep cycles at night.
  • That would be super helpful because then you can actually measure and see some form of data around what is happening. At 90 days, you'll retest your A1C to see if you are moving in the right direction. Your fasting blood glucose levels, all those things are important to be able to see. Now, for proper expectations, about 0.5 to 1.
  • 5 points dropped at 90 days for the general biological environment that takes that much time to get that much out of it. and we start to get that nerve regeneration. If your testosterone panel at 90 days shows free testosterone improving and then SHBG stabilizing, that hormonal loop is starting to figure itself out and work.
  • This isn't a one-mon fix, guys. This is a a sustained lifestyle change that has to improve on a variety of different ways to be able to get back to feeling the way that you want. What to watch. So these are the things. This is what you pay attention to your scorecard in a sense. We've got fasting blood sugar level, but the trend is one week over another.
  • Your waist circumference every two weeks. Your sleep hours in in an app over every night on average. Your postmeal movement strategies and movement overall throughout the day and the week. We've got how many erections do you notice in your day? Literally, you might have to pay attention to that and write it down. what your free testosterone levels are, A1C.
  • These are all things that you're going to pay attention to. Now, if you need help with understanding some of these numbers, I have an improve your blood panel scorecard. And on that, it it measures out it tells you and simplifies exactly what the numbers are inside your blood panels, what they mean. And then I have a 3-day meal plan Kickstarter reset that you can use as well.
  • And that is something that I regularly give out for free. In the show notes, you'll be able to get it. The improve your blood panel scorecard and that directly aligns up with a a very practical real solution that I start my guys out with all the time. So check for that in the show notes. And if you need more help beyond just applying that information, then that's what the Call to Rise program is.
  • It's a 100 day fat loss challenge that helps guys lose weight, get better lifestyle behavior changes, understand nutrition, move their body more effectively and efficiently, and ultimately get into a much better health. In episode 60, I talk about three guys through the holidays lost 98 pounds in my program. And that's the power of having support, having community, having direction in your individual lifestyle.
  • So check that out at thealltorise.com. That'll be in the show notes as well. As we wrap up, three to five years, guys, that is a window that research backs up that men, if you haven't been fixing this or actively paying attention to it, you might have an issue, a cardiovascular event in three to five years. You know the three mechanisms mechanisms driving it.
  • You know that this is the the medication is it may or may not work for you. Okay? You can't rely on like, well, I have ED and I'm just going to take Viagra. That isn't necessarily it. We know that if your waistline is over 40 in, you're headed straight toward a cardiovascular issue or disease. Okay? If you aren't sleeping well and you have collapsed airways, you are incredibly more likely to have poor ability to recover and repair and manage your testosterone.
  • You have to have these conversations active with your partner, your spouse, your wife, with your doctor so that we get real life change and you don't have that issues. Have a heart attack. I literally had one guy one time call me from the hospital bed after his heart attack seeking out help. You do not want to be in that position.
  • Be more proactive than reactive in this situation. This is the thing that I charge you with guys leaving this episode. That's it for Driven for Health. Thank you so much for joining us. I hope that this was educational, informative, and pay attention for more diabetes specific episodes coming out soon