A study of various factors associated with sexual dysfunction in males with type 2 diabetes mellitus
Keywords:Premature ejaculation, Sexual dysfunction, Type 2 diabetes mellitus
Background: SD is very common in type 2 diabetic men. Many middle aged and older adults with diabetes are sexually active, but the rate of sexual inactivity is higher than in non-diabetic subjects. The objective of this study was to study various factors associated with sexual dysfunction in males with type- 2 diabetes mellitus.
Methods: A total of 60 male type 2 diabetic subjects were studied. They were divided in to two groups, 42 subjects with SD were in one group and 18 subjects with normal sexual function were in the second group. Differences between groups were assessed for statistical significance using T-test, Mann-Whitney test and Chi-square test, where ever applicable. The data were presented as Mean±Standard deviation or percentages.
Results: The prevalence of SD was 70%, ED was 93%, Orgasmic dysfunction was 38 %, 9 had HSDD (21%) and 22 had premature ejaculation (52%). The age (p = 0.335), duration of DM (p = 0.097), BMI (p = 0.717), WC (p = 0.138) were not significantly different between two groups. FPG (p = 0.000), PPG (p = 0.000) and HbA1c (p = 0.000) were significantly higher in SD group. Non-HDL cholesterol level (p = 0.001) and TG level (p = 0.021) were significantly higher in SD group. The eGFR (p = 0.150) was not significantly different between two groups. Spot urine protein creatinine ratio (p = 0.002) was significantly higher in SD group.
Conclusions: It was concluded that SD is a highly prevalent problem in males with type 2 DM. ED is the most common form of SD, followed by PE, Orgasmic dysfunction and HSDD. The age, duration of DM, BMI and WC are not associated factors of SD.
World Health Organization. The ICD-10 Classification of mental and behavioral disorders. Geneva: World Health Organization. 1992.
Maria LI. Sexual dysfunction in men with type 2 diabetes. Postgrad Med J. 2012;88:152-9.
Burke JP, Jacobson DJ, McGree ME, Nehra A, Roberts RO, Girman CJ, et al. Diabetes and sexual dysfunction: results from the Olmsted County study of urinary symptoms and health status among men. The J Urol. 2007;177(4):1438-42.
Lindau ST, Tang H, Gomero A, Vable A, Huang ES, Drum ML, et al. Sexuality among middle age and older adults with diagnosed and undiagnosed diabetes: A national, population-based study. Diab care. 2010.
Montorsi P, Ravagnani PM, Galli S, Rotatori F, Briganti A, Salonia A, et al. Common grounds for erectile dysfunction and coronary artery disease. Current Opinion Urol. 2004;14(6):361-5.
American Diabetes Association. Standards of medical care in diabetes-2011. Diab Care. 2011;34(Suppl 1):S11-61.
Grant PS, Lipscomb D. How often do we ask about erectile dysfunction in the diabetes review clinic? Acta Diabetol. 2009;46:285-90.
International Diabetes Federation. Diabetes atlas. International Diabetes Federation. 2009;4.
Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia. 1993;36(2):150-4.
Kroenk K, Spitzer R, Williums W. The PHQ-9. Validity of a brief severity of depression measure. JGIM. 2001;16:606-16.
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives Internal Med. 2006;166(10):1092-7.
Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care. 2008;46(3):266-74.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urol. 1997;49(6):822-30.
Owiredu WK, Amidu N, Alidu H, Sarpong C, Gyasi-Sarpong CK. Determinants of sexual dysfunction among clinically diagnosed diabetic patients. Reproductive Biol Endocrinol. 2011;9(1):70.
Grover SA, Lowensteyn I, Kaouache M, Marchand S, Coupal L, DeCarolis E, et al. The prevalence of erectile dysfunction in the primary care setting: importance of risk factors for diabetes and vascular disease. Archives Internal Med. 2006;166(2):213-9.
Malavige LS, Jayaratne SD, Kathriarachchi ST, Sivayogan S, Fernando DJ, Levy JC. Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido. J Sexual Med. 2008;5(9):2125-34.
Lindau ST, Tang H, Gomero A, Vable A, Huang ES, Drum ML, et al. Sexuality among middle age and older adults with diagnosed and undiagnosed diabetes: A national, population-based study. Diab Care. 2010.
Veves A, Webster L, Chen TF, Payne S, Boulton AJ. Aetiopathogenesis and management of impotence in diabetic males: four years experience from a combined clinic. Diab Med. 1995;12(1):77-82.
Lu CC, Jiann BP, Sun CC, Lam HC, Chu CH, Lee JK. Association of glycemic control with risk of erectile dysfunction in men with type 2 diabetes. J Sexual Med. 2009;6(6):1719-28.
El-Sakka AI. Premature ejaculation in non-insulin-dependent diabetic patients. Int J Androl. 2003;26:329-34.
Vrentzos GE, Paraskevas KI, Mikhailidis DP. Dyslipidemia as a risk factor for erectile dysfunction. Curr Med Chem. 2007;14(16):1765-70.
Hiroshi Y, Hideyuki S, Kenichi O. Prevalence and risk factors of erectile dysfunction in Japanese men with type 2 diabetes. Diabetes Res Clin Pract. 2004;6:S173-S177.
Shlomo M. Williams Textbook of Endocrinology. 12th ed. Saunders; 2011:1493.
Sumeet G, Puneet R, Deepak G. Study of erectile dysfunction in type-2 diabetic patients. Int J Health Care Biomed Res. 2013;1(3):210-6.
Robert CK, Charles BK. Sexual dysfunction in diabetic men. Diabetes. 1974;3(4):317-25.
Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553-79.
Mota M, Lichiardopol C, Mota E, Pănuş C, Pănuş A. Erectile dysfunction in diabetes mellitus. Rom J Inter Med. 2003;41:163-77.