The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus

Kirilmaz, Utku; Güzel, Özer; Aslan, Yılmaz; Balcı, Melih; Tuncel, Altuğ; Atan, Ali

doi:10.3109/13685538.2015.1072154

Cited by 18 publications

(22 citation statements)

References 34 publications

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“…The risk factors and the histopathology that underlie erectile dysfunction are very similar to those affecting the media smooth muscle in the arterial tree in arteriosclerosis and hypertension (8,9). Over 40% of T2D patients with erectile dysfunction are refractory to palliative treatment with oral PDE5 inhibitors taken to induce an erection (10,11), and there are no convincing evidence that improving glycemic control/lifestyle alone reverses erectile dysfunction (12–14). Therefore, new therapies for long-term correction of the underlying histopathology of the penile corpora cavernosa are needed to ameliorate erectile dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Implanted Muscle-Derived Stem Cells Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes, but Their Repair Capacity Is Impaired by Their Prior Exposure to the Diabetic Milieu

Kovanecz

Vernet

Masouminia

et al. 2016

The Journal of Sexual Medicine

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Introduction Muscle derived stem cells (MDSC) and other stem cells implanted into the penile corpora cavernosa ameliorate erectile dysfunction in type 1 diabetic (T1D) rat models by replenishing the lost corporal smooth muscle cells (SMC) and reducing fibrosis. However, no conclusive data on this question in T2/D/obesity models is available. Aim. We studied whether: a) MDSC from T2D Obese Zucker (OZ) rats at an early stage of diabetes (ED-SC), counteract corporal veno-occlusive dysfunction (CVOD) and corporal SMC loss/lipofibrosis when implanted in the OZ rats at a late stage of diabetes; b) MDSC from these late diabetes OZ rats (LD-SC) differ from ED-SC in their gene transcriptional phenotype and repair capacity. Methods and Outcomes ED-SC and LD-SC were compared by DNA microarray assays, and ED-SC were incubated in vitro under high glucose conditions (ED-HG-SC). These three MDSC types were injected into the corpora cavernosa of late diabetes OZ rats (OZ/ED, OZ/LD, and OZ/ED-HG rats respectively). Untreated OZ (OZ/UT) and non-diabetic Lean Zucker (LZ/UT) rats were controls. Two months later, rats were subjected to cavernosometry and the penile shaft and corporal tissues were subjected to histopathology and DNA microarray assays. Results Implanted ED-SC and ED-HG-SC, improved CVOD, counteracted corporal SMC/collagen decrease and fat infiltration in long-term T2D rats, and upregulated nNOS and eNOS. LD-SC acquired an inflammatory/profibrotic/oxidative/dyslipidemic transcriptional phenotype, and failed to repair the corporal tissue. Conclusions MDSC from pre-diabetic rats injected into the corpora cavernosa of long-term diabetic T2D rats improve CVOD and the underlying histopathology. In contrast, MDSC from long-term uncontrolled diabetic T2D rats, are imprinted by the hyperglycemic/dyslipidemic milieu with a noxious phenotype associated with an impaired tissue repair capacity. Diabetes-impacted stem cells may lack tissue repair efficacy as autografts, and should either be reprogrammed in vitro, or substituted by stem cells from allogenic non-diabetic sources.

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Section: Introductionmentioning

confidence: 99%

Implanted Muscle-Derived Stem Cells Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes, but Their Repair Capacity Is Impaired by Their Prior Exposure to the Diabetic Milieu

Kovanecz

Vernet

Masouminia

et al. 2016

The Journal of Sexual Medicine

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“…Amongst them, 14 studies were further excluded from the analysis since they did not fulfill the inclusion criteria with the following reasons: acute doses of PDE-5i, no glycemic outcome and active-controlled trial. The remaining five randomized controlled trials [14] , [15] , [16] , [17] , [18] were included in the qualitative synthesis but one study [18] had to be excluded in the final meta-analysis due to no quantitative data of glycemic parameters. Finally, four studies fit the inclusion criteria and were included in this meta-analysis [14] , [15] , [16] , [17] .…”

Section: Resultsmentioning

confidence: 99%

“…All studies were published in English and used the same PDE-5i, namely sildenafil. Additionally, all trials were double-blind and placebo-controlled in design except one [17] , which compared sildenafil plus lifestyle modification (diet and exercise) and medical treatment for intensive glycemic control versus lifestyle modification (diet and exercise) and medical treatment for intensive glycemic control. One report [14] described the following two comparisons: (i) propionyl l -carnitine (PLC) alone versus PLC combined with PDE-5i (ii) PDE-5i monotherapy versus placebo.…”

Section: Resultsmentioning

confidence: 99%

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Effect of phosphodiesterase-5 inhibitors on glycemic control in person with type 2 diabetes mellitus: A systematic review and meta-analysis

Poolsup

Suksomboon

Aung

2016

Journal of Clinical & Translational Endocrinology

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Chronic use of phosphodiesterase-5 inhibitors (PDE-5i) has been shown to improve insulin action on muscle glucose uptake by the prolongation of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP)/protein kinase (PKG) signalling.AimsAs the effects of PDE-5i on glycemic control in person with type 2 diabetes mellitus (T2DM) have not been systematically explored, we conducted a meta-analysis of available randomized controlled trials (RCTs).MethodsA literature search was performed through electronic databases including MEDLINE (Pubmed), The Cochrane Library, SCOPUS, Web of Science, CINAHL, www.clinicaltrials.gov and www.clinicaltrialresults.org until April 2016 without language restriction. Studies were included if they met the following criteria: (i) RCTs of the chronic use of PDE-5i compared with placebo or no active treatment in T2DM patients (ii) reporting of HbA1c or glycated haemoglobin or fasting plasma glucose (FPG).ResultsFour studies involving a total of 198 patients fit into the inclusion criteria. All included studies used the same PDE-5i, sildenafil. Reports of HbA1c were analysed as only one study reported FPG. PDE-5i had no beneficial effect on HbA1c with weighted mean difference (WMD) of 0.17% (95% CI, −0.64 to 0.97).ConclusionThis meta-analysis suggests that large and well-controlled studies are warranted to shed light on the effect of PDE-5i on glycemic control in people with type 2 diabetes mellitus.

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“…Medikal tedaviye cevap da diyabetik olmayan hastalara kıyasla daha düşüktür (6). Diyabetik erkeklerde ED gelişim mekanizması olarak kavernöz arterlerde endoteliyal hasar, mikroanjiyopati (7) ve otonom nöropati (8) gibi nedenler tanımlanmıştır (9).…”

Section: Introductionunclassified

Erektil disfonksiyonlu diabetes mellitus olgularında penil Doppler ultrasonografi bulguları

2017

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Amaç: Penil Doppler ultrasonografi (US) incelemesi istenen erektil disfonksiyon şikayeti bulunan diabetes mellitus tanılı hastalarda US bulgularının erektil fonksiyon skorlama testi ile karşılaştırılarak değerlendirilmesi amaçlandı. Gereç ve Yöntem:Penil Doppler US incelemesi yapılan 27 hasta prospektif yürütülen bu çalışmaya dahil edildi. Hastalara US ünitesinde, penil kavernöz cisme papaverin enjeksiyonunu takiben Doppler US yapılarak penil kan akımı değerlendirildi. Pik sistolik akım hızı, diyastol sonu hız kaydedilerek Doppler US tanısı belirlendi. Ereksiyon düzeyi, ereksiyon sertlik derecelendirme skalasına göre 4 puan üzerinden değerlendirildi. Erektil fonksiyon için IIEF-5 (erektil fonksiyon uluslararası indeksi) anketi ile skorlama yapıldı ve SHIM (erkekler için seksüel sağlık envanteri) seviyesi belirlendi. Elde edilen Doppler US tanıları ile SHIM seviyeleri karşılaştırıldı. Abstract Aim: To evaluate the correlation between penile Doppler ultrasound (US) findings and erectile function scoring test in patients with diabetes mellitus requested penile Doppler US examination and suffering from erectile dysfunction. Materials and Methods: Twenty-seven patients who underwent penile Doppler US were recruited to this prospective study. Penile blood flow following intracavernosal papaverine injection using Doppler US was evaluated in the ultrasound unit. The peak systolic velocity and end-diastolic velocity were recorded and the diagnosis according to Doppler US was determined. Erection score according to Erection Hardness Grading Scale was evaluated, which ranked the scores from 1 to 4. A scoring for erectile function was performed with the International Index of Erectile Function (IIEF-5), and the Sexual Health Inventory for Men (SHIM) was defined. Doppler US findings were compared with SHIM scales.Results: There were a total of 27 patients with a mean age of 55.74±9.02 (39-70) Conclusion:The rate of vascular problems in diabetic men with erectile dysfunction is high and venous insufficiency was found to be more often in our study.

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The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus

Abstract: Glycemic control and lifestyle changes are not solely adequate for a better sexual function in ED due to diabetes, and sildenafil citrate should be used additionally.

Cited by 18 publications

References 34 publications

Implanted Muscle-Derived Stem Cells Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes, but Their Repair Capacity Is Impaired by Their Prior Exposure to the Diabetic Milieu

Implanted Muscle-Derived Stem Cells Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes, but Their Repair Capacity Is Impaired by Their Prior Exposure to the Diabetic Milieu

Effect of phosphodiesterase-5 inhibitors on glycemic control in person with type 2 diabetes mellitus: A systematic review and meta-analysis

Erektil disfonksiyonlu diabetes mellitus olgularında penil Doppler ultrasonografi bulguları

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