High prevalence of erectile dysfunction in diabetes: a systematic review and meta‐analysis of 145 studies

Abstract

Erectile dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess the relative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ± 7.9 years). The prevalence of erectile dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectile dysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction < 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI, 0.008 to 0.040; P = 0.003; R = 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were at increased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I = 67%, k = 8). Erectile dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with erectile dysfunction is warranted.

Diagnosis of erectile dysfunction can be used to improve screening for Type 2 diabetes mellitus

“…Almost one‐quarter of men with Type 2 diabetes in the present study population had ED. This estimate was smaller than those reported in other studies . The explanation for this difference could lie in the definition of ED used in the present study; we based this on a single question whereas other studies used validated questionnaires to assess ED.…”

“…Our results are conservative and warn of a higher prevalence of comorbid Type 2 diabetes with ED in Peru. In addition to the different instrument used to define ED, our study population was younger than that in many other studies addressing the association between Type 2 diabetes and ED; however, some studies with even younger populations have also reported a high prevalence of ED . This further supports the relevance of the role of ED ascertainment in assessing risk of Type 2 diabetes.…”

Epigenetic silencing of microRNA‐874‐3p implicates in erectile dysfunction in diabetic rats by activating the Nupr1/Chop‐mediated pathway

“…In particular, diabetes causes or exacerbates various disorders in the cardiovascular system. 7,8 Diabetes mellitus erectile dysfunction (DMED) is difficult to treat in part because its primary cause, diabetes itself is difficult to treat, and many affected men avoid seeking timely medical attention. [2][3][4] In addition, it is also well-known that diabetes causes penile erection dysfunction.…”

Treatment for erectile dysfunction among older men in Northern Ireland

“…Overcoming these barriers is not a simple task, but is potentially worthwhile as ED is not only a health condition in of itself but can also be a symptom of cardiac disease as well as having an association with diabetes and depression while men experiencing poorer general health are less likely to be sexually active and more likely to report sexual problems . New ways of breaking down the barriers surrounding discussions of this condition, such as online information, can help in increasing clinical diagnosis of ED.…”

“…Erectile dysfunction (ED) is common among older men and increases with advancing age . In addition to the significant emotional and relationship difficulties that these problems cause, ED is a recognised indicator of cardiovascular disease, and is associated with hypertension, diabetes, and depression . Those with poorer general health are also more likely to report lower levels of sexual activity and higher levels of sexual problems …”