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Published on: Nov 13, 2020
1 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Using The Cellular Handshake Against The Virus

Using the cellular handshake against the virus

In early November an interesting study was published in The Lancet Respiratory Medicine, describing the treatment of a severe COVID-19 patient with human recombinant soluble angiotensin-converting enzyme-2. By using the treatment, it was possible to see the disappearance of the virus swiftly from the patient's serum, nose, and lungs, as well as a reduction in the patients’ inflammatory markers. How was this achieved? And why is this so intriguing.

When we look at treating viruses, there are several strategies at work. You can prevent its spread by the use of social distancing or masks, you can use medications that prevent its replication (such as Tamiflu). Or you can stop the virus from entering the cells, the first step in viral replication.

SARS-CoV-2 appears to enter human cells through the ACE2 receptor. ACE2 is a protein in the cell membrane found across the human body, especially the lungs, heart, kidney and small intestine. It function is related to the Renin-Angiotensin System, a mechanism by which the kidneys control your blood pressure.

Angiotensin-Converting Enzyme converts angiotensin 1 to angiotensin 2, a hormone that causes blood vessels to constrict. ACE 2 instead converts it to a protein that causes dilation of blood vessels. This likely protects these critical organs and ensure they receive sufficient blood to perform their tasks. ACE2 is being investigated as a possible target for blood pressure medications.

The study used a genetically modified soluble form of ACE2 that mimics the protein found on human cell membranes. By increasing its availability in the blood, the SARS-CoV-2 virus binds to this protein, resulting in its inactivation, rather than entering lung cells and causing lung injury. Lab studies have shown that it can reduce viral growth by as much as 1000 to 5000 times, and phase 1 studies show it to be safe to use in people.

The actual described case was in a 45-year-old woman, hospitalized with COVID, suffering from severe shortness of breath, cough and fatigue. She was first treated with hydroxychloroquine and anticoagulants, but this proved ineffective, and the virus was causing increasing damage to her lungs. Nine days after her symptoms started, she received the ACE2 treatment for a week, with no side effects. This resulted in an increase in ACE2 activity (seen from her blood results), but also a marked decrease in multiple inflammatory markers associated with COVID-19, as well as a sharp decrease in COVID 19 numbers. Indeed, the viral load dropped from 32,000 per mL to just 270 per mL two days after treatment started. She was also able to produce antibodies against the virus, so this did not impair her from getting immunity.

It is certainly a very interesting case, though questions remain on how feasible it would be (as well as how expensive) to manufacture large quantities of this protein receptor for treatment use, as well as how it fairs in clinical trials.

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Diabetes Symptoms in Men: Early Warning Signs You Should Not Ignore

Diabetes is one of the fastest-growing health challenges worldwide, and men are particularly vulnerable to its long-term complications. In India, the burden of diabetes has increased sharply over the past two decades, driven by lifestyle changes, sedentary habits and dietary patterns. Despite this, many men remain unaware of early diabetes symptoms or delay medical consultation until complications develop.

Understanding diabetes symptoms in men is essential for early diagnosis, effective management and prevention of serious health consequences.

What Is Diabetes?

Diabetes is a chronic metabolic disorder characterised by high blood sugar levels due to:

insufficient insulin production
ineffective insulin action
or both

The most common form affecting men is type 2 diabetes, which is strongly linked to lifestyle factors.

Why Men Are at Higher Risk

Several factors increase diabetes risk in men:

higher abdominal fat accumulation
smoking and alcohol consumption
irregular eating patterns
work-related stress
lower healthcare-seeking behaviour

According to Indian Council of Medical Research data, a significant proportion of men remain undiagnosed until advanced stages.

Early Diabetes Symptoms in Men

Frequent Urination

Excess sugar in the blood causes kidneys to work harder, leading to increased urination, especially at night.

Excessive Thirst

Frequent urination leads to dehydration, causing constant thirst.

Fatigue and Weakness

Cells cannot utilise glucose efficiently, resulting in low energy levels and persistent tiredness.

Unexplained Weight Changes

Men may experience unexplained weight loss despite normal or increased appetite.

Increased Hunger

Insulin resistance prevents glucose from entering cells, triggering frequent hunger.

Diabetes Symptoms Unique or Commonly Seen in Men

Erectile Dysfunction

Diabetes damages blood vessels and nerves, leading to erectile dysfunction.

Studies show a strong association between diabetes and male sexual health problems.

Reduced Testosterone Levels

Men with diabetes often have lower testosterone, affecting libido, muscle mass and mood.

Decreased Muscle Strength

Poor glucose utilisation affects muscle health and physical stamina.

Skin and Infection-Related Symptoms

Slow-Healing Wounds

High blood sugar impairs wound healing, increasing infection risk.

Frequent Infections

Men with diabetes are more prone to:

skin infections
urinary tract infections
fungal infections

Vision and Nerve Symptoms

Blurred Vision

Fluctuating blood sugar affects eye lenses, causing blurred vision.

Tingling or Numbness

Nerve damage, known as diabetic neuropathy, causes tingling or numbness in hands and feet.

Why Diabetes Symptoms Are Often Ignored by Men

Many men dismiss symptoms as:

work-related fatigue
ageing
stress

This delay increases the risk of complications.

Long-Term Complications of Untreated Diabetes

If untreated, diabetes can lead to:

heart disease
kidney failure
nerve damage
vision loss
sexual dysfunction

According to WHO and Lancet studies, early detection significantly reduces complication risk.

Importance of Early Diagnosis

Early diagnosis allows:

better blood sugar control
lifestyle modification
prevention of organ damage

Routine screening is crucial, even in the absence of symptoms.

When Should Men Get Tested?

Men should consider testing if they:

are over 30 years old
have a family history of diabetes
are overweight
have a sedentary lifestyle
experience any warning signs

Annual screening is recommended for at-risk individuals.

Managing Diabetes After Diagnosis

Effective management includes:

healthy diet
regular physical activity
weight control
stress management
medical treatment as advised

Early management improves quality of life.

Role of Preventive Healthcare

Preventive healthcare focuses on:

early screening
lifestyle intervention
regular follow-up

According to NITI Aayog, preventive strategies are essential to control India’s diabetes burden.

Mental Health and Diabetes in Men

Diabetes can affect mental wellbeing, leading to:

stress
anxiety
depression

Addressing emotional health improves diabetes outcomes.

Breaking the Stigma Around Men’s Health

Men often avoid seeking help due to stigma.

Promoting awareness helps:

normalise health conversations
encourage timely medical care
reduce preventable complications

Conclusion

Diabetes symptoms in men often develop gradually and may go unnoticed for years. Frequent urination, fatigue, unexplained weight changes and sexual health issues should never be ignored. Early diagnosis and timely management significantly reduce the risk of serious complications and improve long-term health outcomes. Awareness, routine screening and proactive healthcare are essential steps for men to protect their health and wellbeing in an era of rising lifestyle diseases.

References

Indian Council of Medical Research (ICMR) – Diabetes Epidemiology and Risk Studies
World Health Organization (WHO) – Diabetes Prevention and Management Guidelines
National Family Health Survey (NFHS-5) – Diabetes Prevalence in Men
Lancet Diabetes & Endocrinology – Male-Specific Diabetes Outcomes
NITI Aayog – Non-Communicable Disease Prevention Reports
Statista – Global Diabetes Trends and Gender Differences

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