Erectile Dysfunction and Quality of Life in Type 2 Diabetic Patients

Abstract

OBJECTIVE -Within the context of a large, nationwide outcomes research program in type 2 diabetes, we assess the prevalence of self-reported erectile dysfunction and evaluate its impact on quality of life.RESEARCH DESIGN AND METHODS -The study involved 1,460 patients enrolled by 114 diabetes outpatient clinics and 112 general practitioners. Patients were asked to complete a questionnaire investigating their ability to achieve and maintain an erection. Various aspects of quality of life were also assessed depressive using the following instruments: SF-36 Health Survey, diabetes health distress, psychological adaptation to diabetes, depressive symptoms (CES-D scale), and quality of sexual life.RESULTS -Overall, 34% of the patients reported frequent erectile problems, 24% reported occasional problems, and 42% reported no erectile problems. After adjusting for patient characteristics, erectile dysfunction was associated with higher levels of diabetes-specific health distress and worse psychological adaptation to diabetes, which were, in turn, related to worse metabolic control. Erectile problems were also associated with a dramatic increase in the prevalence of severe depressive symptoms, lower scores in the mental components of the SF-36, and a less satisfactory sexual life. A total of 63% of the patients reported that their physicians had never investigated their sexual problems.CONCLUSIONS -Erectile dysfunction is extremely common among type 2 diabetic patients and is associated with poorer quality of life, as measured with generic and diabetes-specific instruments. Despite their relevance, sexual problems are seldom investigated by general practitioners and specialists. Diabetes Care 25:284 -291, 2002E rectile dysfunction (ED) is a common complication of diabetes; the reported prevalence ranges from 35 to 70% (1-8). In the Massachusetts Male Aging Study (9), the age-adjusted probability of complete impotence was three times greater (28%) in patients with treated diabetes than in those without diabetes (9.6%). In addition to its higher frequency, ED also occurs at an earlier age in the diabetic population as compared with the general population (1-10) and is often related to duration and severity of diabetes (4,5,8).Although psychogenic factors, such as performance distress, can contribute to its etiology, ED in diabetic patients is mainly related to organic causes, such as vasculogenic and neurological abnormalities (11,12). The presence of a normal sexual desire and the inability to physically act on that desire can affect patients' lives in different ways, including disorders in interpersonal relationships, interference with sexual life, problems with partners, and increase in mental stress, making ED a major quality of life (QoL) issue (13). Recent pharmacological advances have stimulated a great interest in ED, generating new data concerning its prevalence (4,5,(7)(8)(9)14), treatment (15,16), and costs (17,18). Nevertheless, even in randomized clinical trials, little attention has been given to QoL. Instead...

The prevalence and associations of erectile dysfunction in a South African male diabetic urban population

“…The higher prevalence in this study could also be explained by the exclusion of younger patients with diabetes mellitus, compared to other studies. [1][2][3] Univariate associations were age, race, smoking status, SBP, BMI, WC, serum creatinine, the peripheral neuropathy score and diuretic therapy. After multivariate logistic regression, remaining significant factors were age, BMI, the peripheral neuropathy score and diuretic therapy.…”

“…[1][2][3] It occurs at a younger age and with greater frequency in men with diabetes mellitus compared to nondiabetic men. [1][2][3] The prevalence of erectile dysfunction in the general adult population in the USA was found to be between 18% and 31%, with up to 78% of men ≥ 75 years being affected. 4,5 A prevalence of 35% ED was found in a study as early as 1980 in patients with diabetes mellitus.…”

“…22,25,26 Men with diabetes mellitus who develop ED experience a significant decline in quality of life, and an increase in depressive symptoms. 2,27 Depression is also an important factor in the development of ED in patients with diabetes mellitus. The prognosis for ED in men with diabetes mellitus is poor.…”

Urologic Complications of Diabetes

“…ED in diabetic men significantly impacts their quality of life (41,42). The prevalence of disorders of desire, orgasm, and ejaculation has not been determined.…”

“…Erectile dysfunction (ED) occurs in a substantial number of men with diabetes, with prevalence estimates ranging from 20 to 71% (2,40,41). ED in diabetic men significantly impacts their quality of life (41,42).…”