Diabetes Severity, Metabolic Syndrome, and the Risk of Erectile Dysfunction

Abstract

Introduction Erectile dysfunction (ED) is more common in men with type 2 diabetes mellitus (T2DM), obesity, and/or the metabolic syndrome (MetS). Aim To investigate the associations among proxy measures of diabetic severity and the presence of metabolic syndrome (MetS) with erectile dysfunction (ED) in a nationally representative U.S. data sample. Methods We performed a cross-sectional analysis of adult participants in the 2001–2004 National Health and Nutrition Examination Survey (NHANES). Main outcome measures ED was ascertained by self-report. T2DM severity was defined by calculated measures of glycemic control and insulin resistance (IR). Insulin resistance was estimated using fasting plasma insulin (FPI) levels and the homeostasis model assessment of insulin resistance (HOMA-IR) definition. We classified glycemic control using HbA1c and fasting plasma glucose levels (FPG). Metabolic syndrome was defined by the American Heart Association and National Heart, Lung, and Blood Institute criteria. Logistic regression models, adjusted for sociodemographics, risk factors and comorbidities, were fitted for each measure of T2DM severity, MetS, and the presence of ED. Results Proxy measures of glycemic control and insulin resistance were associated with ED. Participants with FPG between 100–126mg/dL (5.6–7 mmol/L) and ≥126mg/dL (>7mmol/L) had higher odds of ED, OR 1.22 [CI, 0.83–1.80] and OR 2.68 [CI, 1.48–4.86], respectively. Participants with HbA1c 5.7–6.4% (38.8–46.4 mmol/mol) and ≥6.5% (47.5 mmol/mol) had higher odds of ED, (OR 1.73 [CI, 1.08–2.76] and 3.70 [CI, 2.19–6.27], respectively). When FPI and HOMA-IR were evaluated by tertiles, there was a graded relation among participants in the top tertile. In multivariable models, a strong association remained between HbA1c and ED (OR 3.19 [CI,1.13–9.01]). MetS was associated with >2.5-fold increased odds of self reported ED (OR 2.55 [CI, 1.85–3.52]). Conclusions Poor glycemic control, impaired insulin sensitivity and the MetS are associated with a heightened risk of ED.

Biochemical Measures of Diabetes are Not Independent Predictors of Urinary Incontinence in Women

“…We also found no relationship between biochemical measures of T2DM and the frequency of incontinence or between diabetes-specific complications and the odds of being incontinent. These findings are in contradistinction to prior research that demonstrated graded relationships between diabetic severity and both kidney stone disease and erectile dysfunction 13,14 .…”

“…We used calculated laboratory measures to define the presence of T2DM as previously described 13,14 . We categorized glycemic control using hemoglobin-A1c (HbA1c) and fasting plasma glucose (FPG) measures according to cutoffs recommended by the American Diabetes Association 15 .…”

Alprostadil for the treatment of impotence

“…It is a well-known fact that ED is more prevalent (35 --90%) [47,48] and occurs at an earlier age in diabetic patients, in particular men who are affected with diabetic vasculopathy and neuropathy [48][49][50][51][52]. It may occur in the early stages of diabetes and occasionally it may be the chief complaint of a diabetic patient.…”

Prevalence and Severity of Erectile Dysfunction as Assessed by IIEF-5 in North Indian Type 2 Diabetic Males and Its Correlation with Variables

“…In a study done by Weinberg AE et al, [7], a poor glycaemic control, impaired insulin sensitivity, and the metabolic syndrome were associated with a heightened risk of ED. Glycaemic control is independently and inversely associated with ED in men with diabetes type 2, as was concluded by Awad H et al, [8].…”