Reducing carbs and sugar in my diet solves the problem and actually negates the need for Viagra etc. There is certainly a mechanism by which high sugar affects erections regardless of use of typical ED drugs. In fact basic Metformin works in this case for minor hyperglycemia or even sugar in control but weaker erections get enhanced by Metformin. I think there is no need for "diabetic" sugar levels to cause ED, some folks can benefit in quality of erection by having "much lower" sugar than normal. This mechanism may explain it but authors need to understand that even normal blood sugar levels can have this type of ED and Metformin or low carb diet helps and Viagra will not.