A 46 year old, male journalist has been attending the Diabetic Clinic regularly over the last 7 years for routine surveillance of his type 2 diabetes, which is well controlled with oral hypoglycaemic agents.

He has a history of excessive alcohol use but now claims that he drinks no more than one unit of alcohol per week. He is a non-smoker.

His overall blood glucose control seems good with home blood glucose monitoring showing fasting concentrations of 5-8 mmol/L and post-prandial glucose concentrations peaking at 9-12 mmol/L. He reports no hypoglycaemic episodes.

On direct questioning, he admits to having a problem getting erections. This has worsened over the last 7-8 months and now he no longer has morning erections. He admits to having little interest in sex and feels generally tired and depressed.