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Evaluation of Erectile Dysfunction in type 2 Diabetes: Prevalence, Clinical characteristics and Treatment effect of sildenafil citrate.
Byoung Hyun Park, Joung Sik Rim, Chung Gu Cho
Korean Diabetes J. 2002;26(3):199-207.   Published online June 1, 2002
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BACKGROUND
The prevalence of erectile dysfunction has been reported to be three times higher in diabetics than nondiabetics. As the majority of type 2 diabetes develops later in life, any associated erectile dysfunction often ignored by physician as well as patients. The purpose of this study was to investigated the prevalence of erectile dysfunction in type 2 diabetes and to find any related clinical characteristics and the effect of sildenafil citrate treatment in these types of patient. METHODS: We studied 75 male type 2 diabetics who visited the Wonkwang University Hospital between March and July, 2000, and analyzed their International Index of Erectile Function questionaires. Erectile dysfunction was defined as a the total score less than 24 points according to the answers to six questions about erections. According to this definition, our patients were divided into two groups; the presence, and the absence, of erectile dysfunction. We also obtained details from the patients relating to their history of smoking, alcohol, consumption, diabetic foots and hypertension; measured their current weight, height, HbA1c, lipoprotein (a), lipid profile, albumin and QTc and evaluated the presence of diabetic retinopathy, nephropathy and neuropathy. A single oral dose of sildenafil, 25 mg, was started and the effect assessed by a global efficacy question every 4 weeks for 12 weeks. If there was no effect, we increased the dose to 50 or 100 mg. RESULTS: 1) The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. Most patients (86.2%) wanted their erectile dysfunction treated, but a minority (31%) had visited a private clinic to discuss the problem. 2) The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The Body Mass Index (BMI) and serum albumin were inversely related to erectile dysfunction. 3) The erectile dysfunction was significantly associated with diabetic autonomic neuropathy and retinopathy. 4) The score from the questionaires of five relevant domains of sexual function (these being, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) were lower in the erectile dysfunctional group. 5) 18 patients were prescribed sildenafil, 61.6% of which reported improved erections by the end of the study, with 50% of these being satisfied with their erections. There were no side effects causing discontinuation of treatment. CONCLUSION: The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The BMI and serum albumin were inversely related to erectile dysfunction. The effect of sildenafil was simillar to that reported previously for other countries, and was effective in the treatment of erectile dysfunction in type 2 diabetics.
Prevalence and Risk Factors of Erectile Dysfunction in Diabetic Men by Self-Reported Questionnaires.
Jin Hwa Lee, Jee Young Oh, Young Sun Hong, Yeon Ah Sung, Nan Ho Kyung, Woo Sik Chung, Eun Young Choi
Korean Diabetes J. 1998;22(4):538-545.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
Erectile dysfunction is the consistent inability to achieve or sustain an erection of suffieient rigidity for sexual intercourse. Erectile dysfunction is an important cause of decreased quality of life in diabetic men. The prevalence of ereciile dysfunction has been reported to be three times higher in diabetic men than nondiabetics. Erectile dysfunction in diabetic men has been associated with increased age, poor glycemic control, smoling, alcohol intake, depression, and microvascular diabetic complication. Our purpose was to determine the prevalence of erectile dysfunction in diabetic men and to assess risk factors re]ated to erectile dysfunction in diabetes mellitus. METHODS: From l53 diabetic men visiting Ewha Womans University Hospital from March, 1997 to March, 1998, we analyzed the self-reported questionnaires. Three questions about erection and one question about overall sexual satisfaetion were given and the answer to each question was categorized into 5 degrees according to the severity of sexua] dysfunction. Erectile dysfunction was diagnosed when any answer for erection showed a degree lower than 4. We obtained the history of smoking, alcohol and hypertension, and measured the current weight and height. Fasting glucose, HBA 1c and lipid profile were me measured. We also evaluated for the presence of diabetic retinopathy, nephropathy and neuropathy. RESULTS: 1) The self-reported prevalence of erectile dysfunction in diabetic men was 75.5 % in this study. 2) In the patients with erectile dysfunction, age, duration of diabetes mellitus, HbAlc, and systolic blood pressure were significantly higher, and BMI and triglyceride significantly lower than in the patients without erectile dysfunction. 3) The prevalence of erectile dysfunction was increased with aging and increasing duration of diabetes mellitus, HBA. was significantly positively related and BMI was inversely related to erectile dysfunction. 4) Age and HbA 1c were independently and positively related to erectile dysfunction by multiple logistic regression. 5) The erectile dysfunction was significantly associated with diabetic autonomic neuropathy and retinopathy. CONCLUSION: The prevalence of self-reported erectile dysfunction in diabetic men was 75.5 % in this study, and it was significantly related to aging and the degree of the glycemic control.

Diabetes Metab J : Diabetes & Metabolism Journal
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