Erectile Dysfunction Should Be a Marker For Diabetes Interview with:

Damiano Pizzol  Operational Research Unit, Doctors with Africa Cuamm Beira, Mozambique

Damiano Pizzol 

Damiano Pizzol 
Operational Research Unit, Doctors with Africa Cuamm
Beira, Mozambique What is the background for this study?

Response: Since the 1970s the association between diabetes and the development of erectile dysfunction has been documented both in animal models and humans Several studies have considered the prevalence of erectile dysfunction in diabetes and the majority agree that the incidence of erectile dysfunction in men with diabetes is two- to three-fold higher than in the general population. It is estimated that erectile dysfunction affects up to 75% of all men with diabetes, it is age correlated and occurs at a younger age in men with diabetes. What are the main findings?

Response: The main outcomes of our meta-analysis, including 145 studies and 88 577 male participants with diabetes, were:
1) erectile dysfunction in men with diabetes is more than three times higher relative to controls;
2) the prevalence of erectile dysfunction in men with Type 2 diabetes is higher compared with those with Type 1 diabetes and many men may already have erectile dysfunction at the diagnosis of Type 2 diabetes. What should clinicians and patients take away from your report?

Response: First of all erectile dysfunction should be considered a marker symptom for diabetes and men with erectile dysfunction should be screened for diabetes (and viceversa).

In addition,  advancing age, duration of diabetes, poor glycaemic control, hypertension, hyperlipidaemia, sedentary lifestyle, smoking and the presence of other diabetic complications are associated with diabetes related erectile dysfunction and, thus, have to be particularly considered in patients with erectile dysfunction.

Finally, considering the association between depressive symptoms and erectile dysfunction, especially in diabetic patients, it is mandatory that the management should involve a multidisciplinary approach in which psychosexual counseling and specialist andrologist/urologist advice is required in addition to the skills and expertise of the specialist in metabolic diseases and to the traditional pharmacological therapy. What recommendations do you have for future research as a result of this study?

Response: It is well known that many  factors contribute to the complex pathogenesis of diabetes-related erectile dysfunction including diabetic neuropathy, micro- and macrovascular arterial disease (oxidative stress, endothelial dysfunction, dyslipidaemia, arterial hypertension, etc.), hypogonadism, psychogenic components and drug side effects.

However, further studies ere necessary to better understand the exact pathophysiologic mechanism leading to dysfunction. Is there anything else you would like to add?

Response: Our analysis shows large differences in the reported prevalence of erectile dysfunction from approximately 35% to 80%, which might be due to differences in methodology and population characteristics. We hope that with international consensus we will come to standardization and harmonization of studies. Thank you for your contribution to the community.


Diabet. Med. 000000000 (2017)

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.




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