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

Abstract

Background: Erectile dysfunction (ED) is a common condition in patients with type 1 or type 2 diabetes mellitus. The prevalence and predictors in our patient population are unknown since minimal data exist for this condition in South Africa. Method: An observational, cross-sectional study was performed on 150 consecutive male patients aged ≥ 50 years, with either type 1 or type 2 diabetes mellitus, attending the Steve Biko Academic Hospital Diabetes Clinic. These patients were evaluated for diabetes mellitus control and medical complications, and for the presence of ED. Morning serum testosterone levels were determined. Results: Some degree of ED was reported in 95% of the patients, with 51% reporting serious dysfunction. Using multivariate logistic regression, it was determined that the significant factors associated with ED were age, body mass index, the peripheral neuropathy score and diuretic therapy. Differences in quality-of-life scores were seen in some ED subgroups. Conclusion: This study confirms the high prevalence of ED in diabetic male patients in a tertiary setting. It is suggested that universal screening should be performed for this population group. Multiple predictors of ED were identified in this study. ED negatively affected quality of life, but not in a statistically significant way.

Prevalence of low serum testosterone levels among men with type 2 diabetes mellitus attending two outpatient diabetes clinics in KwaZulu-Natal Province, South Africa

“…[21] The few available studies in diabetic men have shown that the sensitivity of using questionnaires is high, but that they lack specificity; also, they correlate poorly with serum testosterone, similar to the findings of the present study. [19,22,23] The Pretoria study [7] found that the ADAM questionnaire had a high sensitivity (95%) and low specificity (5%), similar to the findings of a crosssectional survey among 200 Nigerian men with T2DM. [7,24] The value of the AMS and ADAM questionnaires in SSA populations therefore remains unresolved, and they require further validation before they can be recommended in routine practice.…”

“…To date published data are available only from three countries, Nigeria, Ghana and South Africa (SA) ( Table 1). [7][8][9][10][11][12][13] These studies report a high prevalence of low serum testosterone, from 29.5% to 50%. However, only a few studies have investigated the risk factors associated with low testosterone.…”

“…However, only a few studies have investigated the risk factors associated with low testosterone. [7,8,10,11]…”

“…There are limited data on the prevalence of low serum testosterone in men with T2DM from SSA, with only a few studies from Nigeria and a single study each from Ghana and SA. [7][8][9][10][11][12][13] Such studies report the prevalence of LSTT as 29.5 -55%. [7][8][9][10] Compared with the present study, Kemp and Rheeder [7] reported a higher prevalence of LSTT (50%) in 150 men attending a tertiary diabetes clinic in Pretoria, the majority of whom (91%) had T2DM.…”

“…[7][8][9][10][11][12][13] Such studies report the prevalence of LSTT as 29.5 -55%. [7][8][9][10] Compared with the present study, Kemp and Rheeder [7] reported a higher prevalence of LSTT (50%) in 150 men attending a tertiary diabetes clinic in Pretoria, the majority of whom (91%) had T2DM. This finding could be related to the characteristics of the study population, who were older than our subjects (62 v. 57.5 years) and had a longer duration of diabetes (15 v. 11.4 years), a higher mean WC (112 v. 103 cm) and a higher burden of CVD (41% v. 18%).…”