Erectile dysfunction in patients with diabetes mellitus: results of epidemiological monitoring

Abstract

Aim.
Screening for erectile dysfunction (ED) in patients with type 1 and 2 diabetes mellitus.
Materials and methods.
The study included 611 patients with type 1 (n=276) and 2 (n=335) diabetes mellitus. The control group comprised 70 patients.The methods used were a questionnaire survey, HbA_1c measurement, evaluation of renal and cardiovascular function, examination of ocularfundus, lower extremities and genital organs. Differences were considered significant at p<0.05 probability level.
Results.
Prevalence of ED among DM 1 and DM2 patients was estimated at 38.7 and 66.2% respectively compared with 15.7% in controls. It increasedwith patients age and duration of DM. Patients having ED showed poorly compensated metabolic disorders and significantly higher frequency of other diabeticcomplications compared with those without ED. The predominant etiological factor of ED was neuropathy (91.7% in DM1 and 76.3% in DM2). Thecontribution of vasculopathy (19.6% and 47.3% respectively) became apparent with aging of the patients. The vascolugenic form of ED in DM patients precededclinical signs of macroangiopathy in the lower extremities at least in 53% cases and myocardial infarction in 25.7%. Neurogenic ED developed priorto clinical manifestations of diabetic neuropathy at least in 46.1% of the patients. General practitioners diagnosed ED not more than in 22.7% patients.
Conclusion.
ED is a common complication of DM depending on the quality of its compensation, duration of the disease, and patients age. Active casedetection of ED is necessary since it may be a clinical marker of neuropathy and macroangiopathy. Adequate correction of metabolic disturbancesmay reduce the number of patients with ED. The risk of ED may be used as a motivational factor for the patients.