Predictors of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Referred to a Tertiary Healthcare Centre

Abstract

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.

Risk factors of erectile dysfunction among diabetes patients in Africa: A systematic review and meta-analysis

“…Five of the studies included in this review were from Nigeria [46] , [47] , [48] , [49] , [50] , four from Ethiopia [51] , [52] , [53] , [54] , three from Ghana [32] , [55] , [56] , one each from South Africa [57] , Egypt [31] , Kenya [58] , Zimbabwe [59] , and Tanzania [60] . Concerning the sampling technique 12 of the studies [31] , [32] , [46] , [47] , [48] , [49] , [50] , [54] , [55] , [56] , [58] , [59] used consecutive sampling to select study participants. However, one study [60] did not report the sampling method.…”

“…Different diagnostic criteria were used to assess ED in DM patients. These consisted of 11 studies used the International Index of Erectile Function tool [31] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [58] , [59] , [60] . Two of the studies used the Golombok Rust Inventory of Sexual Satisfaction criteria [32] , [55] .…”

“…However, in most the studies the method to assess this association was varied. In the majority of studies, correlates of ED included systolic and diastolic high blood pressure, long duration of diabetes, older age, glycosylated haemoglobin, autonomic neuropathy, and obesity [31] , [32] , [46] , [47] , [48] , [49] , [51] , [52] , [53] , [57] , [58] , [59] .…”

“…Therefore, five cross-sectionall studies were included in the final analysis. The pooled effects of five studies [47] , [48] , [51] , [52] , [58] showed that a duration of diabetes for >10 years was statistically associated with ED in patients with DM (OR = 2.63; 95%CI; 1.27, 5.43). The heterogeneity test (I 2 = 72.2%) shows moderate evidence of variation across studies ( Fig.…”

Performance of the Androgen Deficiency in Aging Male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus

“…21 Similarly, erectile dysfunction is a common complication of DM, occurring in over 70% of men with type 2 DM. 22 Therefore, it is deducible that the non-specific nature of the components of the ADAM questionnaire may be responsible for its poor overall efficiency in identifying male androgen deficiency.…”