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Erectile dysfunction common in diabetes
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Erectile dysfunction may go undiagnosed in more than half the men with diabetes who are affected by the condition, according to results from a systematic review and meta-analysis.
“It is well known that many factors contribute to the complex pathogenesis of diabetes-related erectile dysfunction including diabetic neuropathy, micro- and macrovascular arterial disease (oxidative stress, endothelial dysfunction, dyslipidemia, arterial hypertension, etc.), hypogonadism, psychogenic components and drug side effects,” Damiano Pizzol, MD, PhD, of the operational research unit at Doctors with Africa CUAMM in Mozambique, told Endocrine Today. “However, further studies are necessary to better understand the exact pathophysiologic mechanism leading to dysfunction.”
Pizzol and colleagues conducted a systemic review and meta-analysis on 145 studies that included 88,577 men (mean age, 55.8 years) to determine the prevalence of erectile dysfunction among men with type 1 and type 2 diabetes.
Overall, the prevalence of erectile dysfunction in diabetes was 59.1%. However, across countries, the prevalence was different (P < .0001), with the highest prevalence in South America (74.6%; one study), Oceania (74.4%; one study) and Africa (71.3%; 15 studies), and lowest in studies conducted in North America (34.5%; 17 studies).
Men with type 2 diabetes had a higher prevalence of erectile dysfunction (66.3%; 70 studies) compared with those with type 1 diabetes (37.5%; 12 studies; P < .0001). Erectile dysfunction prevalence was also higher in studies conducted using the Sexual Health Inventory for Men questionnaire compared with those that did not, and in studies with older participants (mean age, > 60 years) compared with younger participants.
Based on eight studies, the prevalence of erectile dysfunction in men was doubled in men with diabetes (51.6%) compared with healthy controls (25.5%; OR = 3.62; 95% CI, 2.53-5.16).
“First of all, erectile dysfunction should be considered a marker symptom for diabetes and men with erectile dysfunction should be screened for diabetes,” Pizzol told Endocrine Today. “In addition, advancing age, duration of diabetes, poor glycemic control, hypertension, hyperlipidemia, sedentary lifestyle, smoking and the presence of other diabetic complications are associated with diabetes related erectile dysfunction and, thus, have to be particularly considered in patients with erectile dysfunction. Finally, considering the association between depressive symptoms and erectile dysfunction, especially in diabetic patients, it is mandatory that the management should involve a multidisciplinary approach in which psychosexual counseling and specialist andrologist/urologist advice is required in addition to the skills and expertise of the specialist in metabolic diseases and to the traditional pharmacological therapy.” – by Amber Cox
For more information:
Damiano Pizzol, MD, PhD, can be reached at d.pizzol@cuamm.org.
Disclosures: The authors report no relevant financial disclosures.
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