Reduced carbohydrate intake can improve erectile function in men with high A1C, but usually indirectly: by improving blood glucose, insulin resistance, weight, blood pressure, triglycerides, and vascular function.
The strongest point is this: high A1C is associated with erectile dysfunction in type 2 diabetes, and worse glycemic control tends to mean worse erectile function. Studies in diabetic men have found higher HbA1c linked with ED, along with related issues like metabolic syndrome, hypertension, low HDL/high triglycerides, and depression.
The ADA says reducing overall carbohydrate intake has some of the strongest evidence for improving glycemia in people with diabetes, and low-carb patterns can be one valid option when matched to the person’s needs and medications.
There is also some direct evidence: a small randomized trial in men with metabolic syndrome/hypogonadism found that a low-carb diet improved erectile-function scores by about 2.4 points on the IIEF-5 scale. That is not a miracle cure, but it is a meaningful signal.
The important nuance: lower carb helps most when it lowers A1C and improves cardiovascular health. Erectile function depends heavily on blood-vessel function, nitric oxide signaling, nerve health, testosterone status, medication effects, sleep, stress, and blood pressure. If diabetes has already caused neuropathy or vascular damage, diet may help but may not fully reverse it.
A practical version would be: reduce refined carbs and sugars first, then consider a moderate lower-carb approach — for example, fewer grains/starches per meal, more protein, vegetables, olive oil, nuts, fish, eggs, yogurt, legumes if tolerated. Extreme keto is not automatically better, especially if it raises LDL cholesterol or is hard to sustain.
One warning: if someone is on insulin, sulfonylureas, or certain diabetes medications, dropping carbs quickly can cause low blood sugar, so medication may need adjusting with a clinician.
So the answer is: yes, very plausibly — but the target is not “low carb” by itself; the target is lower A1C, better vascular health, and improved metabolic function. For ED with high A1C, I’d think of carb reduction as one of the most useful foundational moves, alongside walking/resistance training, sleep, weight loss if needed, blood-pressure control, and medical treatment when appropriate.