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LETTER TO EDITOR
Year : 2020  |  Volume : 19  |  Issue : 1  |  Page : 73-74  

Prevalence of erectile dysfunction among Greek men with type 2 diabetes mellitus


First Department of Internal Medicine, Diabetes Centre, Tzaneio General Hospital of Piraeus, Piraeus, Greece , Greece

Date of Submission08-Jul-2019
Date of Acceptance02-Nov-2019
Date of Web Publication13-Mar-2020

Correspondence Address:
Dr. Athanasia K Papazafiropoulou
1 Zanni and Afentouli Street, Piraeus 185 36
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aam.aam_32_19

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How to cite this article:
Papazafiropoulou AK, Anagnostopoulou K, Petropoulou K, Melidonis A. Prevalence of erectile dysfunction among Greek men with type 2 diabetes mellitus. Ann Afr Med 2020;19:73-4

How to cite this URL:
Papazafiropoulou AK, Anagnostopoulou K, Petropoulou K, Melidonis A. Prevalence of erectile dysfunction among Greek men with type 2 diabetes mellitus. Ann Afr Med [serial online] 2020 [cited 2020 Nov 25];19:73-4. Available from: https://www.annalsafrmed.org/text.asp?2020/19/1/73/280499



Sir,

Erectile dysfunction (ED) is a chronic complication of type 2 diabetes (T2D), often underdiagnosed, resulting in poor quality of life. According to studies, the prevalence of ED varies from 35% to 90% among diabetic men.[1] However, little is known on the prevalence of ED in T2D men in our country. Therefore, the aim of the present study was to estimate the prevalence of ED in a sample of Greek T2D men.

Our sample consisted of consecutive 106 men with T2D examined at the Diabetes Centre of General Hospital of Piraeus “Tzaneio” from September to December 2018. Exclusion criteria were severe renal disease, hepatic or cardiorespiratory disease, malignancy, connective tissue disease, and acute illness. A detailed medical history, including demographic data, physical examination, and fasting blood sample analysis were performed. Participants were asked to complete the short version of the International Index of Erectile Function-5 (IIEF-5).[2] ED was defined as IIEF-5 score <21 and was graded as follows: 17–21 mild ED, 12–16 mild-to-moderate ED, 8–11 moderate ED, and 1–7 severe/complete ED.[2] All data were assessed for normal distribution by the Kolmogorov–Smirnov test. Multivariate logistic regression analysis was used to identify independent risk factors of ED. P < 0.05 (two-tailed) was considered statistically significant.

Most (95.3%) of the study participants were on oral agents and 19.8% on insulin. 79.1% of the study participants had hypertension, 90.7% had dyslipidemia, 3.5% cerebrovascular disease, 10.5% peripheral arterial disease, 7% retinopathy, 14% diabetic neuropathy, 16.3% chronic kidney disease (CKD), 41.9% coronary artery disease, and 24.7% were current smokers. Most (95.3%) of the study participants were on oral hypoglycemic agents, and 19.8% were receiving insulin.

The prevalence of ED was 91.8%. Severity of ED was as follows: 36.5% mild ED, 18.8% mild-to-moderate ED, 10.6% moderate ED, and 25.9% severe-to-complete ED. 18.6% of the study participants were receiving pharmacological treatment for ED. Multivariate logistic regression analysis, after adjustment for age, T2D duration, body mass index, HbA1c, smoking status, hypertension, antidiabetic treatment, and micro- and macrovascular complications showed that ED was associated positively with dyslipidemia (odds ratio [OR]:1.07, 95% confidence interval [CI]: 1.01–1.16) and negatively with glomerular filtration rate (GFR) (OR: 0.92, 95% CI: 0.86–0.99).

In the present study, we found a high prevalence of ED was 91.8% among T2D men. It must be mentioned that the prevalence of ED varies according to the characteristics of the studied population.[1] In an Italian study, approximately 60% of T2D men exhibited ED: mild 9%, mild to moderate 11.2%, moderate 16.9%, and severe 22.9%.[3] In our study, dyslipidemia and GFR levels were the only predictors of ED. Previous studies have shown that dyslipidemia is an independent risk factor for ED in T2D.[4] It is known that men with dyslipidemia are more likely to have ED, but the responsible pathogenetic mechanisms are not fully understood.[4] In addition, it has been well established that CKD is related to sexual disorders. ED prevalence in patients with CKD is high and the manifestation is classified as severe in more than half of them.[5] ED and CKD share common pathophysiological causes, such as vascular or hormonal abnormalities and are both affected by similar comorbid conditions, such as cardiovascular disease, hypertension, and T2D.[5]

In conclusion, the prevalence of ED among Greek diabetic men is high. Dyslipidemia and GFR were identified as the only determinants of ED. However, larger, well-designed studies are needed to give an answer to the prevalence of this important diabetic complication in our country.

Financial support and sponsorship

None.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Defeudis G, Gianfrilli D, Di Emidio C, Pofi R, Tuccinardi D, Palermo A, et al. Erectile dysfunction and its management in patients with diabetes mellitus. Rev Endocr Metab Disord 2015;16:213-31.  Back to cited text no. 1
    
2.
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the international index of erectile function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11:319-26.  Back to cited text no. 2
    
3.
Giugliano F, Maiorino M, Bellastella G, Gicchino M, Giugliano D, Esposito K, et al. Determinants of erectile dysfunction in Type 2 diabetes. Int J Impot Res 2010;22:204-9.  Back to cited text no. 3
    
4.
Krassas GE, Tziomalos K, Papadopoulou F, Pontikides N, Perros P. Erectile dysfunction in patients with hyper and hypothyroidism: How common and should we treat? J Clin Endocrinol Metab 2008;93:1815-9.  Back to cited text no. 4
    
5.
Zheng H, Fan W, Li G, Tam T. Predictors for erectile dysfunction among diabetics. Diabetes Res Clin Pract 2006;71:313-9.  Back to cited text no. 5
    




 

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