How often do we ask about erectile dysfunction in the diabetes review clinic?

Abstract

Diabetic neuropathy is a significant complication of chronic diabetes. We wished to discover whether we were successfully identifying patients who had developed neuropathic problems. Specifically, Diabetologists are traditionally poor at asking about erectile dysfunction (ED) and patients themselves are not always forthcoming as it an embarrassing medical problem. We targeted all patients attending diabetes review clinics over a 4-month period in two hospitals and asked them to complete an anonymous, self-reported questionnaire after their consultation with the diabetologist or diabetes specialist nurse. Whilst most aspects of diabetic neuropathy are routinely screened for in the diabetes clinic we found that the neuropathic symptoms of both ED and gastroparesis were not commonly enquired about, and that erectile failure was found to be more prevalent than previously. Diabetologists need to be more thorough in their assessment of diabetic neuropathy. This is especially of import with regards to ED because we often shy away from enquiring into such a personal area and male patients rarely highlight the issue due to embarrassment. Our post consultation questionnaire has now been modified to form a useful preconsultation neuropathy screening tool and this is undergoing validation.

A study of various factors associated with sexual dysfunction in males with type 2 diabetes mellitus

“…6 However, few diabetic men with SD are diagnosed and treated. 7 Type 2 diabetes mellitus (DM) is one of the most common forms of chronic diseases globally. In 2010, 80% of the 285 million people having diabetes were living in less developed countries.…”

Erectile dysfunction in general medicine

“…The Endocrine Society recommends routine measurement of testosterone levels in patients with type 2 diabetes, but even diabetologists can be tardy in checking this. 2 Studies to date have demonstrated strong benefits resulting from testosterone replacement, but this treatment should be individualised and under specialist supervision until long-term studies fully establish its benefits and risks.…”

“…2 Factors that need to be covered include speed of onset (gradual development of symptoms usually indicates an organic cause, whereas sudden onset ED often has a psychological or traumatic cause), duration since onset, relation to the patient's libido, whether the ED is partial or complete, the circumstances under which the ED is likely to occur, and whether the patient is still able to get spontaneous morning erections (this last issue also being a good marker of testosterone status). Physical examination should focus on the patient's blood pressure, peripheral pulses, testicular size and volume, secondary sexual characteristics and any obvious anatomical defects of the penis.…”

Reliability of Information Abstracted from Diabetic Patients' Medical Records in Palestine

“…Selfreporting of diabetes-specific data has been shown to present moderate validity and be prone to both under and overreporting. [13,[15][16][17][18][19][20] These studies found variable agreement for eye examinations and eye problems, [17,[19][20][21] diabetic foot, [13,21] erectile dysfunction, [15,16] microalbuminuria, [20,21] levels of glycosylated hemoglobin, [20,21] lipids, [21] blood pressure [2,21] and organ amputation [17].…”