The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes

Abstract

Background. The purpose of this study was to evaluate the effect of diet and antihyperglycemic drugs on erectile dysfunction (ED) in a setting of subjects affected by diabetes mellitus (DM) or preDM. Methods. This is a prospective observational study on 163 consecutive subjects with preDM or DM. All patients have undergone a medical evaluation (age, Body Mass Index (BMI), family history of DM, duration of DM, smoking, physical activity, dyslipidemia, cardiovascular comorbidities, and testosterone and HbA1c levels) and the International Index of Erectile Function (IIEF)-5 questionnaire. Results. Overall, the mean age was 62.8 ± 9.3 years, and the mean BMI was 28.4 ± 4.6 kg/m2. The IIEF-5 score mean value was 14.4 ± 6.2 (range 4–25). Among all confounders investigated for their association with the IIEF-5 score, only age and the duration of DM among diabetic patients showed a significant trend. The IIEF-5 score was higher in patients using GLP-1a compared to insulin (16.7 ± 4.7 vs. 12.9 ± 6.2; p = 0.02). This association was confirmed after adjustment for age and duration of DM (p = 0.01). All other treatments were similar (14.9 ± 6.2, 14.8 ± 9.2, 15.3 ± 5.4, and 13.6 ± 6.8 for metformin, sulfonylureas (SU), dipeptidyl-peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) treatment, respectively). Conclusions. This prospective observational study increases attention and focus on the effect of antihyperglycemic drugs and diet on ED, above all about the role of new classes, showing a significant higher IIEF-5 mean value in patients using GLP-1a compared to patients on insulin treatment.

Erectile Dysfunction Severity: The Role of Glycometabolic Compensation and Antihyperglycemic Drugs

“…This result was in accordance with other reports, which highlighted that the IIEF-5 score is higher in patients on therapy with new antidiabetic drugs, in particular with GLP1-Ras, compared to the scores obtained by patients treated with insulin or old antidiabetic drugs [ 9 , 37 ]. So far, the studies conducted on the impact of GLP1 and SGLT2i on male sexual function have mostly been conducted on mouse models, but the results seem to be encouraging [ 38 , 39 ].…”

The effects of non-andrological medications on erectile dysfunction: a large single-center retrospective study

“…The authors observed that patients treated with liraglutide showed a significant improvement in erectile function compared to the group that received only testosterone and metformin; therefore, this finding underlines a potential protective effect of GLP-1a on sexual function. Similar results were observed by Defeudis et al [ 18 ], who found in a prospective observational study that patients treated with GLP-1a showed a better erectile function than patients treated with insulin; the results were also confirmed after adjustment for age and duration of DM. Nevertheless, diabetes is closely related to cardiovascular disease [ 19 ].…”

Association between dietary inflammation and erectile dysfunction among US adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2001–2004

“…Finally, two sensitivity analyses were additionally performed to assess the robustness of our findings. In the first sensitivity analysis, we excluded participants taking medicines that potentially affect erectile function, including antidepressants (42), antipsychotics (43), antihyperglycemic agents (9,44), sex hormones and corticosteroids (45). In the second sensitivity analysis, a stricter criterion of ED was used.…”