Risk factors of erectile dysfunction among diabetes patients in Africa: A systematic review and meta-analysis

Abstract

Background Erectile dysfunction in men is a common underestimated complication of diabetes mellitus, which is becoming a significant public health problem both in developing and developed countries. Erectile dysfunction threatens the well-being of clients, hence determining its risk factors and controlling it at an early stage is vital to preventing serious consequences and the burden of the disease. Therefore, this study aimed to systematically evaluate erectile dysfunction risk factors in patients with diabetes mellitus in Africa. Methods PubMed, Web of Science, Scopus, African Journals Online, Wiley Online Library and Google Scholar were searched and complemented by manual searches. Egger's regression test was used to determine publication bias. The I 2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, odds ratios, and 95% confidence interval across studies. STATA version 14 statistical software was used for the meta-analysis. Result Overall, 17 studies with 6002 study participants were included to identify risk factors of erectile dysfunction among diabetic patients. Duration of diabetes mellitus >10 years (AOR = 2.63; 95% CI 1.27, 5.43), age >40 years (AOR = 1.24; 95% CI: 1.03, 1.51), peripheral neuropathy (AOR = 2.34; 95% CI: 1.51, 10.72), no physical exercise (AOR = 1.63; 95% CI: 1.49, 1.78), testosterone level <8 nmol/l (AOR = 2.83; 95% CI: 1.06, 12.86), and peripheral vascular disease (AOR = 2.85, 95% CI: 1.54–5.27) were significantly associated with erectile dysfunction among diabetic patients. Conclusions This study found that long duration of diabetes mellitus, age >40 years, testosterone deficiency, peripheral neuropathy, not involved in physical exercise, peripheral vascular disease, were significantly associated with increased risk of erectile dysfunction among diabetic patients Therefore, situation-based interventions and country context-specific preventive strategies should be developed to decrease the risk factors of erectile dysfunction among patients with diabetes mellitus.

Changes in Sexual Functions and Alexithymia Levels of Patients with Type 2 Diabetes During the COVID-19 Pandemic

“…Besides, the fact that a significant portion of the patients (42.5%) in our study were 65 years of age or older is thought to be related to the high rate of decrease in sexual functioning both in the pre-pandemic period and during the pandemic. This is because sexual dysfunctions are associated with age in diabetes [ 39 ]. In addition, the HbA1c levels of the patients in our study being 9.40 ± 2.26, and the mean duration of diabetes being 9.06 ± 4.02 years are thought to increase sexual dysfunction.…”

“…The information form created by the researchers was prepared in line with the literature [ 38 , 39 ]. The form includes questions about socio-demographic characteristics (age, gender, marital status), number of chronic diseases other than diabetes, duration of diabetes, HbA1c level in the last 3 months, and sexual functioning.…”

The psychological impact of diabetes as a risk factor for erectile dysfunction

“…This highlights the importance of thoroughly tracking psychological symptoms as a risk factor for ED. However, no studies within this report track anxiety as a risk factor and only one study tracks depression [1] . In comparison, 16 out of the 17 studies track age as a risk factor [1] .…”

“…As medical students studying in the United Kingdom, we found the article ‘Risk factors of erectile dysfunction among diabetes patients in Africa: A systematic review and meta-analysis’, by Wondimeneh Shibabaw Shiferaw et al [1] to be of great interest. The main limitation identified in this report was the lack of consideration regarding the psychological impact of diabetes and how this may contribute to erectile dysfunction.…”

“…The systematic review identifies the following risk factors for erectile dysfunction amongst diabetes patients in Africa: duration of diabetes mellitus, age, testosterone deficiencies, amount of physical exercise, peripheral neuropathy and peripheral vascular disease [1] . Whilst we acknowledge that these are risk factors, we believe there should be further investigation into the psychological impact of diabetes as a risk factor for erectile dysfunction.…”