Erectile dysfunction in men with diabetes mellitus

Maatman, Thomas J.; Montague, Drogo K.; Martin, Lawrence

doi:10.1016/0090-4295(87)90097-5

Cited by 37 publications

(17 citation statements)

References 12 publications

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“…However, evidence for the hormonal pathway is much weaker than evidence for vascular and neural pathways (2,3,7,19,42). When we examined the effect of diabetes duration on the occurrence of fatal and nonfatal myocardial infarction among the men in this study, the odds increased gradually with increasing diabetes duration (odds ratio ϭ 1.3, 95% CI 0.9 -1.7, for 0 -5 years; 1.9, 1.3-2.6, for 6 -10 years; 2.9, 2.0 -4.2, for 11-15 years; 3.6, 2.3-5.5, for 16 -20 years; and 3.6, 2.6 -5.0, for Ͼ20 years).…”

Section: Research Design and Methods -mentioning

confidence: 99%

Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Bacon¹,

Hu²,

et al. 2002

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OBJECTIVE -Differences in risk of erectile dysfunction (ED) by characteristics of diabetes among older men are not well understood. We examined the association of type and duration of diabetes with erectile function in men Ͼ50 years of age in a large prospective cohort study. RESULTS -Men with diabetes had an age-adjusted relative risk (RR) of 1.32 (95% CI 1.3-1.4) for having ED compared with men without diabetes. In multivariable regression analyses, men with type 1 and type 2 diabetes were at a significantly higher risk for ED (type 1 diabetes RR ϭ 3.0, 95% CI 1.5-5.9; type 2 diabetes RR ϭ 1.3, 1.1-1.5) than nondiabetic men. Men with type 2 diabetes had an increasingly greater risk of ED with increased duration since diagnosis (trend test P value Ͻ0.0001) (RR ϭ 1.7, 95% CI 1.1-2.7, for men diagnosed Ͼ20 years previously). CONCLUSIONS -For men over age 50 years, increasing duration of diabetes was positively associated with increased risk of ED relative to nondiabetic subjects. This association persisted despite the higher prevalence of other comorbid conditions. ED prevention and diabetes management efforts are likely to go hand-in-hand. RESEARCH DESIGN AND METHODS

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Section: Research Design and Methods -mentioning

confidence: 99%

Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Bacon¹,

Hu²,

et al. 2002

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“…Alteration of neural and impaired penile vascular systems is believed to be primarily responsible for ED rates approaching 75% in some reports. [1][2][3][4][5] In contrast to efficacy in general population of 70-89%, just slightly over 50% of diabetic men respond favorably to this treatment. 6 The underlying cause of this relative treatment resistance remains poorly characterized.…”

Section: Introductionmentioning

confidence: 99%

Effect of PDE5 inhibition combined with free oxygen radical scavenger therapy on erectile function in a diabetic animal model

Young

Freeman

et al. 2003

Int J Impot Res

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Phosphodiesterase (PDE) inhibitors represent an important advance in the treatment of erectile dysfunction (ED). In spite of widespread use and generally good efficacy, as a class they remain ineffective in 15-57% of men. Specific cohorts of patients with severe vascular or neurogenic basis to their ED, such as diabetic men or those who have undergone radical pelvic surgery, demonstrate lower response rates with PDE inhibition treatment. We believe that circulating levels of nitric oxide (NO) may be enhanced through delivery of adequate concentrations of free oxygen radical scavenger molecules such as vitamin E. Higher levels of NO, theoretically, should produce increased penile blood flow with the potential for a synergistic effect when combined with a PDE5 inhibitor. With this hypothesis in mind, 20 adult male Sprague-Dawley streptozotocin-induced (60 mg/kg i.p.) diabetic rats were divided into four therapeutic groups (n ¼ 5). Group IFcontrol animals received peanut oil, group IIFvitamin E 20 IU/day, group IIIFsildenafil 5 mg/kg/day and group IVFvitamin E 20 IU/day plus sildenafil 5 mg/kg/day, by oral gavage daily for 3 weeks. Erectile function was assessed as a rise in intracavernous pressure following cavernous nerve electrostimulation. Penile tissue was harvested to determine the changes in tissue morphology including neuronal nitric oxide synthase, smooth muscle a-actin and endothelial cell integrity. PDE5 protein content and activity were measured. Significant increases in intracavernous pressure were measured in the animals receiving combined vitamin E plus sildenafil treatment. Immunohistochemical staining showed increases of neuronal nitric oxide synthase, endothelial cell and smooth muscle cell staining. Western blot analysis did not show significant differences of PDE5 protein between the groups. However, higher PDE5 activity was measured in the sildenafil group and lower activity of PDE5 was recorded in the cohort receiving vitamin E with sildenafil. Vitamin E enhanced the therapeutic effect of the PDE5 inhibitor in a meaningful way in this animal model of diabetes. This study indicates a potential means of salvaging erectile function among patients who are refractory to sildenafil.

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“…11) The copulatory behavior of diabetic rat has been collapsed 12) along with low fertility in induced normal mating. 12) In human, diabetes is associated with erectile dysfunction 13,14) along with loss of libido 1,5) and abnormal morphology of sperm, low plasma levels of gonadotrophins and testosterone. 15) Though there are several reports about dysfunctions of the male reproductive activity in diabetic state but the data are confusing, and the exact role that insulin plays in the regulation of male reproductive function is still unclear.…”

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confidence: 99%

Protection of Testicular Dysfunctions by MTEC, a Formulated Herbal Drug, in Streptozotocin Induced Diabetic Rat

Mallick

Mandal

Barik

et al. 2007

Biological & Pharmaceutical Bulletin

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Diabetes is associated with declining sexual function in both male 1) and female 2) individuals. In case of female, diabetic symptoms consistent with autonomic neuropathy associated with decreased subjective sexual arousal. 3) In recent study Erol et al. noted that women with type 2 diabetes experienced higher prevalence rates of sexual dysfunction when compared to non diabetic. 4) Approximately 80% of diabetic patients complained loss of libido, 60% had diminished clitoral sensitivity, 50% experienced organic dysfunction, 40% experienced vaginal discomfort, and 40% experienced vaginal dryness. 5) Type 1 diabetic women experienced higher prevalence of reduced vasocongestion and reduced vaginal lubrication to erotic stimuli. 6) Thus these clinical studies suggest that both type 1 and type 2 impede the sexual arousal responses in women.Male reproductive alterations have been widely reported in model animals and human with diabetes. 7) Streptozotocin induced diabetes in male rats resulted atrophy of sex organ, changes in histoarchitecture of ventral prostate, 8) diminution in sperm count, 8) along with low levels in plasma gonadotrophins 9,10) and testosterone. 11) The copulatory behavior of diabetic rat has been collapsed 12) along with low fertility in induced normal mating. 12) In human, diabetes is associated with erectile dysfunction 13,14) along with loss of libido 1,5) and abnormal morphology of sperm, low plasma levels of gonadotrophins and testosterone. 15) Though there are several reports about dysfunctions of the male reproductive activity in diabetic state but the data are confusing, and the exact role that insulin plays in the regulation of male reproductive function is still unclear.In traditional practice, medicinal plants are used in many countries to control diabetes mellitus. The National Centre for Complementary and Alternative Medicine, established in 1998 by the United States Government where development of herbal medicine is one of the important subjects of study. 16,17) Moreover the herbal drug is of first choice at present because plant drugs are to be less toxic and more free from side effect than synthetic one. 18) M. paradisiaca is a tree like herb belonging to the Musaceae family and different parts of the plant have medicinal value. 19,20) T. indica LINN is tree type of plant belonging to the Caesalpiniaceae family was used as a traditional medicine for the management of diabetes mellitus. 21) E. Jambolana is used as traditional medicine for the management of diabetes. 19) This plant is found all over India and belongs to the Myrtaceae family. Jambu bark cure hemorrhages, burning sensation, dysentery, diarrhea, diabetes, excessive thirst, dyspepsia, cough and asthma and is used in preparation of astringent decoction for gargles and washes. 20) Seeds are used for the treatment of diabetes. 20) Coccinia indica is under Cucurbitaceae family and has medicinal importance as observed earlier by others. 22) In our previous work we have reported the antidiabetic effect of some of these plant pa...

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Erectile dysfunction in men with diabetes mellitus

Cited by 37 publications

References 12 publications

Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men

Effect of PDE5 inhibition combined with free oxygen radical scavenger therapy on erectile function in a diabetic animal model

Protection of Testicular Dysfunctions by MTEC, a Formulated Herbal Drug, in Streptozotocin Induced Diabetic Rat

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