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 The study of data on nearly 90,000 men found those with diabetes are
three and a half times more likely than men without the disease to
have difficulty maintaining an erection, according to the report in
Diabetic Medicine.
Because erectile dysfunction can be a sign of the often silent
cardiovascular issues that go along with diabetes, doctors should
take the sexual complaint as a cue to screen for both diabetes and
heart disease, the study team writes.
“Erectile dysfunction, due to its evident presentation, can play a
crucial role in early diabetes mellitus diagnosis and acts as an
alarm bell for other silent complications,” said study coauthor Dr.
Damiano Pizzol, coordinator of the Operational Research Unit of
Doctors with Africa Cuamm in Beira, Mozambique.
Since 1980, the number of people with diabetes worldwide has soared
from 108 million to 422 million, the study team writes, and the
prevalence among adults has increased from 4.7 percent to 8.5
percent.
Although erectile dysfunction is most common in men over age 40, it
can occur at any age alongside diabetes and heart disease, they
note.
“Too often, the lack of prevention, an unhealthy diet and lack of
physical exercise leads to a late diagnosis of diabetes,” Pizzol
told Reuters Health by email. Many times, he added, complications
like erectile dysfunction lead to the initial diabetes diagnosis.
The researchers analyzed 145 studies that included 88,577 men to
understand how common erectile dysfunction is with diabetes. Most of
the studies were conducted in Asia and Europe, and half focused only
on men with type 2 diabetes, the more common form of the disease
that’s associated with age and obesity.
The research team found that overall, 37.5 percent of men with type
1 diabetes and 66.3 percent of those with type 2 diabetes had
erectile dysfunction. Rates varied significantly across countries
and were highest in South America and lowest in North America.
Erectile dysfunction also developed about 10 to 15 years earlier in
men with diabetes compared to men without the disease.
“Raising awareness of erectile dysfunction and other related men’s
health issues would encourage a much-needed discussion, which is
often overlooked or even avoided by patients and health care
professionals,” said Dr. Laith Alzweri, a urology fellow at Tulane
University School of Medicine in New Orleans who wasn’t involved in
the study.
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“Erectile function could be viewed as an indirect parameter of a
man’s general well-being, both mental and physical,” Alzweri told
Reuters Health by email.
In addition to screening for diabetes when men complain of erectile
dysfunction as the study authors recommend, screening for erectile
dysfunction by health care professionals should be part of the
routine assessment of diabetic men, he said.
A major limitation of the analysis is that only a quarter of the
studies included information about complications associated with
diabetes. Also, studies included in the analysis could vary in the
diagnosis of erectile dysfunction, the type of diabetes, diagnosis
of complications, diabetes health care offerings and insurance
coverage, especially across countries, said Dr. Zdravko Kamenov of
Alexandrovska University Hospital in Sofia, Bulgaria, who wasn’t
involved in the study.
“The large regional variations are intriguing,” he told Reuters
Health by email. “Cultural, psychological and other factors could
affect the reported rates of erectile dysfunction.”
Diabetes is estimated to reach 322 million cases worldwide by 2025,
and erectile dysfunction is cited as the third most frequent
complication of diabetes, he noted.
Future studies should focus on other long-term diabetes risk factors
associated with erectile dysfunction, such as smoking and length of
diagnosis. The exact hormonal, physical and psychological
connections between diabetes and erectile dysfunction could also
point researchers toward new treatment options, Kamenov said.
“Erectile function is a window to men’s health,” he added. “In most
cases, one question is enough to open the window.”
SOURCE: http://bit.ly/2h6uZfu Diabetic Medicine, online July 18,
2017.
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