Background.The frequency of erectile dysfunction (ED) complicating diabetes mellitus (DM) is reportedly high. However, its risk factors have not been well studied.Methods.This was a cross-sectional study of 160 male type 2 DM adults, aged 30–70 years, attending a tertiary healthcare clinic. Demographic and relevant clinical information was documented. Erectile function was assessed using an abridged version of the International Index of Erectile Function (IIEF-5). All subjects were evaluated for central obesity, glycemic control, peripheral arterial disease (PAD), autonomic neuropathy, dyslipidemia, and testosterone deficiency.Results.152 (95%) patients with a mean age of 60.3 ± 8.8 years completed the study. 71.1% had varying degrees of ED, while 58.3% suffered from a moderate-to-severe form. Independent predictors of ED [presented as adjusted odds ratio (95% confidence interval)] were longer duration of DM, 1.14 (1.02–1.28), PAD, 3.87 (1.28–11.67), autonomic neuropathy, 3.51 (1.82–6.79), poor glycemic control, 7.12 (2.49–20.37), and testosterone deficiency, 6.63 (2.61–16.83).Conclusion.The prevalence of ED and its severe forms was high in this patient population. Poor glycemic control and testosterone deficiency were the strongest risk factors for ED, making it possibly a preventable condition.

The prevalence of Type 2 diabetes mellitus (T2DM) continues to climb in many parts of the globe in association with the rise in Obesity.In parallel to the increase in the prevalence of diabetes mellitus, evidence indicates a high prevalence of vitamin D deficiency Worldwide. Areas with high prevalence of vitamin D insufficiency and deficiency have been associated with a higher prevalence of diabetes. The reported prevalence of vitamin D deficiency among subjects with Type 2 diabetes mellitus ranges from 63.5% to 91.1%.Most studies on vitamin D status among Diabetes mellitus subjects involved Caucasians. Data on this subject matter is scarce in Africa. Materials and methods:This study was conducted between the months of May and August (Rainy/winter season) at the Diabetes clinic of the Lagos University Teaching Hospital, LUTH, Lagos, Nigeria. It was an analytical cross-sectional study. A total of 114 eligible type 2 diabetes mellitus participants and 60 healthy controls participated. All participants were clinically assessed and blood samples for relevant investigations taken. Serum vitamin D level was analyzed using the High Performance Liquid Chromatography (HPLC) method. Results:The mean age was 52 ± 7.6 years in the T2DM group and 50 ± 8.4 in the control group, (p = 0.9).The female to male ratio in both T2DM and healthy control subjects was 1.5:1.Majority of the study subjects had vitamin D deficiency with prevalence of 72 (63.2%) in T2DM subjects and 32 (53.3%) in the controls (p = NS). There was no significant difference in the distribution of Vitamin D3 deficiency status by age or sex in both T2DM and Control groups.The mean serum vitamin D level in T2DM subjects with vitamin D deficiency was 9.2 ± 1.1 ng/dl and 21.5 ± 0.7 ng/dl in the sufficient group (t = 11.9, p = 0.0001). The mean HbA1c and Fasting plasma glucose were higher in the vitamin D deficient group compared to the sufficient group (7.5 ± 1.9% and 148 ± 60.9 mg/dl vs. 6.8 ± 1.6% and 134 ± 43.5 mg/dl respectively, p NS). The proportion of subjects with good glycaemic control (HbA1C f 7.0%) was significantly higher in the vitamin D sufficient group 19 (73.1%) compared to the vitamin D deficient group, 33 (45.8%), Z = -2.39, p = 0.01). Conclusion:Vitamin D deficiency is common among the participants in this study. This alludes to the widespread vitamin D deficiency and insufficiency in both apparently healthy populations and patients with various pathologies including diabetes mellitus. The season of study (rainy/winter) may have contributed to the low levels of vitamin D among the participants.

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Aims: The morbidities and mortalities associated with diabetes are disproportionately high in low and middle income countries. This study aimed to explore important barriers and facilitators to diabetes care in Nigeria from the perspectives of diabetes healthcare providers (DHPs). Study Design: A nationwide descriptive survey. Place and Duration: Onsite (Calabar, Nigeria) and online surveys conducted between September 2016 and March 2017.  Methodology: A validated self-administered questionnaire was used to assess barriers to diabetes care and strategies to improve care among DHPs in Nigeria. Results: A total of 129 subjects with mean ± SD age and mean ± SD duration of practice of 42.4 ± 7.6 years and 8.5 ± 5.4 years respectively were surveyed. About 84.5% of the respondents perceived diabetes care in Nigeria as being remarkably challenging. The most common barriers identified include: poverty, low diabetes awareness, shortage of trained diabetes care specialists, poor diabetes care knowledge among primary care doctors, and poor knowledge of diabetes self care among patients and other institutional, cultural and religious barriers. To improve care, respondents recommended, among other strategies, increasing healthcare funding, expansion of national health insurance coverage, introduction of government subsidy on diabetes medications, encouraging local production of diabetes medicines and supplies, increasing public diabetes awareness, periodic training of general practitioners and strict regulation of alternative medicine practitioners and faith healing centers. Conclusion: This survey identified several barriers to diabetes care in Nigeria and proffered some useful and implementable strategies to improve care. In order to reduce the burden of diabetes in Nigeria and perhaps other countries in SSA, these expert opinions should form the basis for a blue print by major diabetes stakeholders and health policy makers.

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