OBJECTIVE -This study aimed to 1) examine the prevalence of sexual problems in women with type 1 diabetes, 2) compare this prevalence rate with that of an age-matched control group, 3) study the influence of diabetes-related somatic factors on female sexuality, and 4) study the influence of psychological variables on the sexual functioning of both groups. RESEARCH DESIGN AND METHODS-A total of 120 women with diabetes visiting the outpatient diabetes clinic completed questionnaires evaluating psychological adjustment to diabetes, marital satisfaction, depression, and sexual functioning. Medical records were used to obtain data on HbA 1c , use of medication, BMI, and early-onset microvascular complications. An age-matched control group of 180 healthy women attending an outpatient gynecological clinic for preventive routine gynecological assessment also completed the non-diabetes-related questionnaires.RESULTS -More women with diabetes than control subjects reported sexual dysfunction (27 vs. 15%; P ϭ 0.04), but a significant difference was found only for decreased lubrication. No association was found between sexual dysfunction and age, BMI, duration of diabetes, HbA 1c , use of medication, menopausal status, or complications. Women with more complications, however, reported significantly more sexual dysfunctions, and the presence of complications altered treatment satisfaction. Both diabetic and control women with sexual dysfunction mentioned lower overall quality of the marital relation and more depressive symptoms than their respective counterparts without sexual problems. Depression was a significant predictor for sexual dysfunction in both women with diabetes and control subjects.CONCLUSIONS -Sexual problems are frequent in women with diabetes. They affect the overall quality of life and deserve more attention in clinical practice and research. Diabetes Care 25:672-677, 2002D iabetes is known to cause multiple medical, psychological, and sexual problems (1-5). Erectile dysfunction is a well-established complication of diabetes (6). The sexual functioning of women with diabetes has received much less attention in clinical research (7). However, a recent review about diabetes and female sexuality indicated that diabetes slightly increases the risk of female sexual dysfunction (8). The most common sexual dysfunction in women with diabetes is decreased sexual arousal with slow and/or inadequate lubrication. Women with diabetes may, however, also experience a decreased sexual desire and more pain on sexual intercourse, whereas problems with orgasm are not more frequent (8).Research on diabetes and female sexual dysfunction is not only scarce, it also has been plagued by methodological flaws such as small sample size, absence of a control group, and noncharacterization as to diabetes type, presence and number of diabetic complications, psychological adjustment to diabetes, quality of the partner relation, and depression (5,8).The present study aimed to 1) examine the prevalence of sexual problems in women with type...

OBJECTIVE -This study aimed to 1) measure the prevalence of sexual dysfunction in patients with diabetes; 2) describe how descriptive variables, psychological variables, diabetic complications, and sexual dysfunction relate in patients with diabetes; and 3) describe the predictors of sexual dysfunction in patients with diabetes. RESEARCH DESIGN AND METHODS-A total of 240 adult type 1 diabetic patients visiting the outpatient diabetes clinic of a university hospital completed questionnaires evaluating psychological adjustment to diabetes and sexual functioning. Medical records were used to obtain HbA 1c values as well as information on microvascular diabetic complications.RESULTS -Sexual dysfunction was reported by 27% of women and 22% of men. No differences were found between sexes in type of reported sexual dysfunction. In men, but not in women, sexual dysfunction was related to age, BMI, duration of diabetes, and diabetic complications. No correlation with HbA 1c was found in either sex. In women, but not in men, sexual dysfunction was related to depression and the quality of the partner relationship. Binary logistic regression demonstrated that, in men, the significant predictors of sexual dysfunction were higher age and presence of complications, whereas, in women, sexual dysfunction was related to depression.CONCLUSIONS -Both women and men with diabetes are at increased risk for sexual dysfunction. This study suggests that in men with diabetes, sexual dysfunction is related to somatic and psychological factors, whereas in women with diabetes, psychological factors are more predominant. Diabetes Care 26:409 -414, 2003D iabetes is known to cause multiple medical (1), psychological (2), and sexual (3) dysfunctions. Impaired sexual function in men is a welldocumented complication of diabetes. Several studies have shown that men with diabetes are at increased risk for erectile dysfunction, that it occurs at an earlier age (4 -8), and that it is related to longer duration of diabetes, poor metabolic control, and the presence and number of diabetic complications (9).Although women run the same risk to develop diabetic complications, the sexual problems of women with diabetes have received much less attention in research and clinical practice (10). Although it has often been suggested that diabetes has no influence on female sexual functioning, in a review, we formulated the hypothesis that women with diabetes (compared with men) are also at increased risk for sexual dysfunction (3,11). Moreover, in a recent controlled study, comparing women with diabetes and control subjects, we demonstrated that significantly more women with diabetes (27%) than control subjects (15%) reported sexual dysfunction and that a significant difference was found only for decreased lubrication (12). Furthermore, no association was found between sexual dysfunction and age, BMI, diabetes duration, diabetic complications, HbA 1c , medication use, or menopausal status (12).The debate about the etiology of sexual dysfunction of patients with d...

Benign peripheral nerve sheath tumors (PNSTs) are a characteristic feature of neurofibromatosis type I (NF1) patients. NF1 individuals have an 8-13% lifetime risk of developing a malignant PNST (MPNST). Atypical neurofibromas are symptomatic, hypercellular PNSTs, composed of cells with hyperchromatic nuclei in the absence of mitoses. Little is known about the origin and nature of atypical neurofibromas in NF1 patients. In this study, we classified the atypical neurofibromas in the spectrum of NF1-associated PNSTs by analyzing 65 tumor samples from 48 NF1 patients. We compared tumor-specific chromosomal copy number alterations between benign neurofibromas, atypical neurofibromas, and MPNSTs (low-, intermediate-, and high-grade) by karyotyping and microarray-based comparative genome hybridization (aCGH). In 15 benign neurofibromas (4 subcutaneous and 11 plexiform), no copy number alterations were found, except a single event in a plexiform neurofibroma. One highly significant recurrent aberration (15/16) was identified in the atypical neurofibromas, namely a deletion with a minimal overlapping region (MOR) in chromosome band 9p21.3, including CDKN2A and CDKN2B. Copy number loss of the CDKN2A/B gene locus was one of the most common events in the group of MPNSTs, with deletions in low-, intermediate-, and high-grade MPNSTs. In one tumor, we observed a clear transition from a benign-atypical neurofibroma toward an intermediate-grade MPNST, confirmed by both histopathology and aCGH analysis. These data support the hypothesis that atypical neurofibromas are premalignant tumors, with the CDKN2A/B deletion as the first step in the progression toward MPNST.

Aims/hypothesis This study aimed to determine the characteristics and pregnancy outcomes across different subtypes of gestational diabetes mellitus (GDM) based on insulin resistance. Methods GDM subtypes were defined in 1813 pregnant women from a multicentre prospective cohort study, stratified according to insulin resistance, based on Matsuda index below the 50th percentile of women with normal glucose tolerance (NGT), during a 75 g OGTT at 24-28 weeks' gestation. GDM was diagnosed in 12.4% (n = 228) of all participants based on the 2013 WHO criteria. Results Compared with women with NGT (1113 [61.4%] of the total cohort) and insulin-sensitive women with GDM (39 [17.1%] women with GDM), women with GDM and high insulin resistance (189 [82.9%] women with GDM) had a significantly higher BMI, systolic BP, fasting plasma glucose (FPG), fasting total cholesterol, LDL-cholesterol and triacylglycerol levels in early pregnancy. Compared with women with NGT, insulin-sensitive women with GDM had a significantly lower BMI but similar BP, FPG and fasting lipid levels in early pregnancy. Compared with women with NGT, women with GDM and high insulin resistance had higher rates of preterm delivery (8.5% vs 4.7%, p = 0.030), labour induction (42.7% vs 28.1%, p < 0.001), Caesarean section (total Caesarean sections: 28.7% vs 19.4%, p = 0.004; emergency Caesarean sections: 16.0% vs 9.7%, p = 0.010), neonatal hypoglycaemia (15.4% vs 3.5%, p < 0.001) and neonatal intensive care unit admissions (16.0% vs 8.9%, p = 0.003). In multivariable logistic regression analyses using different models to adjust for demographics, BMI, FPG, HbA 1c , lipid levels and gestational weight gain in early pregnancy, preterm delivery (OR 2.41 [95% CI 1.08, 5.38]) and neonatal

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