Introduction

The intersection of tight foreskin (phimosis), balanitis, and Diabetes presents a complex interplay of factors that can significantly impact men's sexual health. In this blog, we'll discuss Diabetes and circumcision and explore evidence-based strategies for optimal care.

Medical Indications for Circumcision

In diabetic men, we have identified three main conditions where circumcision may be necessary: balanitis xerotica obliterans (BXO), recurrent balanitis and symptomatic phimosis.

Insights from Recent Studies

Recent epidemiological research has investigated the relationship between type 2 diabetes mellitus and certain penile conditions that might require circumcision. Researchers Wang et al., in a nationwide population-based study, found that type 2 diabetes significantly 42% increased the risk of penile inflammatory disorders like BXO and refractory phimosis.

Correlation Between Diabetes and Penile Inflammatory Disorders like Balanitis

Another study by Hirji et al. from the UK General Practice Research Database showed that diabetes patients were nearly three times more likely to develop balanitis compared to those without Diabetes.

Fakjian et al., in an outpatient setting, discovered that uncircumcised men with Diabetes had a 35% prevalence of symptomatic phimosis, indicating a potential association between Diabetes and tight foreskin.

Clinical Indicators and Demographic Patterns of Diabetes

Certain clinical presentations, like balanoposthitis with a distinctive appearance, have been proposed as early indicators of undiagnosed Diabetes, particularly in older age groups. In the fifty- to sixty-year-old age group, a staggering 83.3% of circumcised patients had Diabetes. This indicates that Diabetes might not only increase the risk of penile inflammatory diseases but also drive the need for circumcision in adult males.

Type 2 diabetes mellitus and the likelihood of undergoing circumcision

A notable recently published study conducted in 2024 analysed a large population from 1997 to 2010 to explore the influence of type 2 diabetes mellitus on the likelihood of undergoing circumcision among men aged 30 to 69. The findings revealed that individuals with Diabetes were significantly more likely to opt for circumcision compared to those without Diabetes, further strengthening the association between diabetes and circumcision decisions.

Conclusion: Implications for Circumcision in TYPE 2 Diabetes

The accumulating evidence underscores a substantial link between diabetes mellitus, penile inflammatory diseases, and tight foreskin, potentially increasing the likelihood of circumcision in affected individuals. In conclusion, the research showed a relationship between Diabetes and penile health, leading to more circumcision in Diabetes.

Preparation for circumcision with Diabetes at London Circumcision Centre

1. It is essential to check Hb1C within six months before circumcision.

2. The level of Hb1C should be less than 70 mmol/mol (8.6%) before the operation.

3. Antibiotics may be required after the circumcision.

4. Diabetes must be controlled after circumcision to prevent delayed wound healing

5. A biopsy is needed if signs of an inflammatory condition called BXO are diagnosed during the examination.

6. Follow-up is required 4-6 weeks after circumcision.

This information is only guidance and not a replacement for professional opinion by our urologist.

References

1. https://londoncircumcisioncentre.co.uk/blog-circumcision/Diabetes/tight-foreskin

2. BMC Urol. 2024; 24: 3. Published online 2024 Jan 3. doi: 10.1186/s12894-023-01392-6

3. https://londoncircumcisioncentre.co.uk/blog-circumcision/cracks_foreskin