Brief Answer:
Urine test suggested

Detailed Answer:
Hello,

First and foremost, it seems to me that the medicines you are taking for sugars are keeping the sugars under control (after the recommended dose modification).
If you are having a feeling of smell in the urine, I would recommend testing urine routine microscopy, urine culture/sensitivity and urine ketones.
I would recommend letting me know the reports as soon as possible.

As for the erectile dysfunction, this may be developing due to the excess sugars that may be leading to diabetic autonomic neuropathy.
The first and most important step in this is the treatment of the diabetes and strict glucose control. I would suggest testing HbA1C.
For symptomatic treatment, I would suggest trying sildenafil 50 half hour prior to the act. A cardiac check up is advisable prior to initiation of taking of the medicine.

Thanks.

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Brief Answer:
specific information as asked

Detailed Answer:
Hello.
Thanks for your response.
I will be answering the specific questions put up by you.
1.     Yes, wine and beer should be avoided. As far as possible. They do increase your sugars and therefore also the HbA1C. So I would ideally recommend not taking wine/beer at all.
2.     Empagliflozin is known to cause yeast infections. This infection can itself cause you to have the smell in the urine. Therefore I had requested the tests.
3.     Sildenafil is to be taken only half hour prior to the act as I mentioned before. It is not to be taken in a regular dose. It does have cardiac side effects. Therefore I said that a cardiac test should be done before starting the medicine.
4.     Sildenafil can be taken with Eritel. Assuming the latter has been started for BP, not a heart problem. In case of a heart problem, sildenafil should be avoided with or without eritel.
I hope this helps clarify your doubts.
Best of luck,
Dr Saumya Mittal, MD

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