Diagnosed with Type 1 diabetes a little over 20 years ago.  Blood sugar control has been not been very good the last year (last A1c test was a whopping 12.1%).  I quit smoking after nearly 30 years of over a pack/day.  When first diagnosed with ED(about 6 years ago), even the minimum dosage of Viagra was sufficient for quality erections.  I was very happy with the results.  My endocrinologist suggested Cialis as the side effects of Viagra (heartburn, stuffy head, headaches) were enough to discontinue use.  Once again, I was pleased with the results and less side effects combined with a more flexible medication that offered longer efficacy with the no rushing of "let's hurry up and do it".  Over the past 2 years of use, I've had less success with both the use of both Cialis and Viagra as erections have been less than satisfactory.  I even tried a combination of 20 mg of Cialis several hours before and 100 mg of Viagra about 1 hour prior to sex with only "fair" results.  This has become so frustrating that it has resulted in the loss of my relationship with my girlfriend and I don't want to subject this to any future woman.  Would a Urologist be better qualified than my Endocrinologist to both make a diagnosis and, suggest treatment(s)?   Is it possuible that my ED symptoms will improve with cardiovascular improvement? Please help.