Erectile Dysfunction in Diabetes May Be Underestimated
The chance of men developing erectile function disorders increases as they get older. Diabetes mellitus can increase the risk of erectile dysfunction further. In a study of 351 men who had recently received a diagnosis of diabetes mellitus, scientists from the German Diabetes Center (DDZ) in Düsseldorf found that erectile dysfunction also occurs in men who have just developed diabetes and that the prevalence of erectile dysfunction varies between the diabetes subtypes. Medscape spoke with the study author, Haifa Maalmi, MD, research associate at DDZ, about the results of the study and what they mean for clinical practice. A thread for discussion.
The relatively high prevalence (23%) of erectile dysfunction in men within a year of their diabetes diagnosis that was observed in our study did not surprise.
Firstly, a diabetic metabolism is often present months or years before the actual diagnosis; and although the German diabetes study includes people with a known diabetes duration of less than a year, the exact diabetes duration is unknown.
Secondly, most diabetes complications (including erectile dysfunction) develop during the prediabetic stage, when hyperglycemia is above the normal value but still below the diabetes threshold value. Early damage to the arteries in the penis may have even developed during the prediabetes phase and led to erectile dysfunction shortly after the diagnosis.
Thirdly, the erectile dysfunction prevalence determined in our study corresponded to the prevalence determined in earlier studies with men in whom diabetes had only recently developed (20% to 37%).
In this context, it should also be noted that the erectile dysfunction prevalence in newly diagnosed diabetes, as in our study, is much lower than in men with a longer diabetes duration (prevalence between 35% and 90%). However, if you consider that our study subjects are relatively young (average age, 49 years), a prevalence of 23% can still be seen as high. There is a correlation between age and a worse erectility (recognizable through lower values in the International Index of Erection Function).
In clinical practice, the subject of sexual performance can be perceived to be too personal and sensitive. Therefore, many men (particularly older men who are not very sexually active) do not go to the doctor and remain undetected.