I am treating my T2 with diet alone and it is working, I am positive my next A1C will show me as non-diabetic or borderline pre-diabetic. So I would prefer no meds and want to keep it that way. However, as I have felt the impact of age the past 2 years (I am in late 40's), I noticed the usual stuff: Gray hairs here & there (mostly in beard, chest, but minor), slightly thinning hair at my scalp line, a little less energy, started needing reading glasses. None of those I consider too huge of a deal but I have noticed around mid-year last year that my, um, ability to be at attention and stay there started to not be great. Have never once had a problem with that. And when I say never, I mean absolutely never. It seems that in the past 2 months it is very noticeable and I am sure performance anxieties may be compounding any physical issues. I had researched after getting diagnosed with T2 that ED is prevalent. BUT it is not clear in research so far whether it's specifically because of one or more of the following: - The insulin resistance -- I mean, having a great diet along to bring sugar levels down and put effort to naturally make the body insulin-sensitive is great, but it's not clear whether the resistance itself is core to the problem or not. - The blood sugar levels. It SEEMS like nephropathy is a factor, so bringing blood sugars down is of great importance. It's not clear, however, whether nephropathy issues "down there" are irreversible. I am fairly certain I only shifted into the diabetic zone sometime in the past 2 years so it's no like my body has been seeing high blood sugars for a long time. I have also read that low testosterone may actually be a trigger to shift men predisposed to T2 into T2, exacerbating the problem. - Low testosterone. Clearly low testosterone is an issue, and clearly age impacts this, but it's not clear whether this needs to be treated as a separate issue or is caused/exacerbated by T2 or whether low T itself exacerbates T2. I plan to see a urologist and get some clarity. I the meantime my research shows totally contradictory findings. Examples: This study says metformin is bad for ED: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296448/ But this says it helps address ED: https://www.diabetes.co.uk/news/201...help-treat-erectile-dysfunction-94362346.html So which is it? Also, the first link shows research for metformin vs sulfonylurea and a control group of non-T2 men (taking no meds) and indicates sulfonylurea (the 2nd prescribed med for T2) as being better for testosterone levels (and this, better to address ED) but it increases chance of heart failure by 30%! Also, in that study, they had no control group of T2 men who took neither med and no lifestyle change, and no control group of T2 men who took neither med but did do lifestyle changes. I guess us men who try to lead a healthy life without meds are not worth studying? I am sure this topic has been looked into by the men here and wondering what findings or real-world application of solutions has been seen to work the best? I had thought by addressing my blood sugars it would become a non-issue but it seems like the opposite. It also gives me pause to wonder about the medications.