The prevalence of diabetic impotence

Abstract

Summary.In a survey of 541 diabetic males, aged 20-59 years, 190 (35%) had erectile impotence. Using linear logistic regression models for analysis the five most significant associations with impotence were age (p < 0.001), treatment with either insulin or oral hypoglycaemic agents (p < 0.001), retinopathy (p < 0.001), symptomatic peripheral neuropathy (p < 0.001) and symptomatic autonomic neuropathy (p < 0.005). The greatest correlations were found in patients with severe microangiopathy, as demonstrated by proliferative retinopathy and symptomatic autonomic neuropathy. In addition the duration of diabetes and the presence of ischaemic heart disease, nephropathy and poor diabetic control may also be associated with diabetic impotence. It is concluded that diabetic impotence is still a common problem and may have a multifactorial aetiology.Key words: Diabetic impotence, prevalence, aetiological factors.The increased frequency of impotence in the diabetic male has long been recognised [7]. Despite improvement in the treatment of diabetes since the early insulin era there has been no decrease in recent reports of the frequency of diabetic impotence [7,10,14]. Thus the prevalence of impotence with increasing age in diabetic men aged between 20-60 years is still approximately 18-71% [19] and considerably greater than 0.1-18.4% for the corresponding normal male population [13].There has been no previous extensive survey of the prevalence of diabetic impotence in the United Kingdom. The aim of the present study was therefore to ascertain the prevalence in males attending a large U. K. diabetic clinic. An assessment was also made of possible contributing factors involved in the aetiology of diabetic impotence. Materials and MethodsDuring a nine month period 563 males attending the Diabetic Out-Patient Department were interviewed. A total of 132 clinics were covered and at each clinic every male aged between 20-59 years was included. After three months an initial non-randomised group of 319 men (Group 1) had been interviewed. At this time it was decided to interview a random group of approximately 100 men to exclude the possibility of bias in the original group. The total clinic male population aged 20-59 years was 887 and from the remaining 568, a random sample of 101 men (Group 2) was drawn who were subsequently interviewed over a six month period. Over this latter period a second non-random group of 121 men (Group 3) who were attending the clinic and not included in the random sample were also interviewed.The total number of men included for study was thus 541, representing 61% of the male clinic population aged between 20-59 years. A further 22 who were unable to give satisfactory interviews were omitted: in the two non-random groups (Groups 1 and 3) 9 were mentally defective, 2 had cerebrovascular accidents with dysphasia and 2 were unable to speak English; in the random group (Group 2) 5 had recently left the area, 1 was hospitalised elsewhere, 2 were mentally defective and 1 had a cerebrovascular accident.A deta...

Experimental diabetes mellitus inhibits prostacyclin synthesis by the rat penis: pathological implications

“…"Long-term" non-ketonuric diabetes led to a marked diminution in PGI2 release, a result which is in accord with those previously reported for aortic PGI2 production [5] and with the epidemiology of impotence in diabetics [1,2]. However, the acute and severe metabolic disturbance created by ketotic diabetes had no effect on penile PGI2 production.…”

“…The prevalence of sexual impotence in diabetic patients is appreciably greater than that in the normal population [1,2]. Since penile erection involves considerable and acute vasodilation, with a concomitant increase in blood flow, it is likely that powerful vasodilators are released locally immediately before and during erection.…”

The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction

“…36 One recent study 37 evaluated sexual function (IIEF items 1 -5), presence or absence of peripheral neuropathy, and glycemic control in 78 male patients with type 2 diabetes. The mean EF score ( AE s.d.)…”

The prevalence and associations of erectile dysfunction in a South African male diabetic urban population

“…4,5 A prevalence of 35% ED was found in a study as early as 1980 in patients with diabetes mellitus. 1 The prevalence of ED was found to be 49% in men aged 40-88 years in a Canadian study, 6 while severe ED was found in 30% of men in a large study in Israel. 7 A prevalence of ED of as high as 71% was also demonstrated in another study in France.…”

“…[1][2][3] It occurs at a younger age and with greater frequency in men with diabetes mellitus compared to nondiabetic men. [1][2][3] The prevalence of erectile dysfunction in the general adult population in the USA was found to be between 18% and 31%, with up to 78% of men ≥ 75 years being affected. 4,5 A prevalence of 35% ED was found in a study as early as 1980 in patients with diabetes mellitus.…”