Evaluation of Erectile Dysfunction in type 2 Diabetes: Prevalence, Clinical characteristics and Treatment effect of sildenafil citrate

Park, Byoung Hyun; Rim, Joung Sik; Cho, Chung Gu

Abstract

BACKGROUND: The prevalence of erectile dysfunction has been reported to be three times higher in diabetics than nondiabetics. As the majority of type 2 diabetes develops later in life, any associated erectile dysfunction often ignored by physician as well as patients. The purpose of this study was to investigated the prevalence of erectile dysfunction in type 2 diabetes and to find any related clinical characteristics and the effect of sildenafil citrate treatment in these types of patient.
METHODS
We studied 75 male type 2 diabetics who visited the Wonkwang University Hospital between March and July, 2000, and analyzed their International Index of Erectile Function questionaires. Erectile dysfunction was defined as a the total score less than 24 points according to the answers to six questions about erections. According to this definition, our patients were divided into two groups; the presence, and the absence, of erectile dysfunction. We also obtained details from the patients relating to their history of smoking, alcohol, consumption, diabetic foots and hypertension; measured their current weight, height, HbA1c, lipoprotein (a), lipid profile, albumin and QTc and evaluated the presence of diabetic retinopathy, nephropathy and neuropathy. A single oral dose of sildenafil, 25 mg, was started and the effect assessed by a global efficacy question every 4 weeks for 12 weeks. If there was no effect, we increased the dose to 50 or 100 mg.
RESULTS
1) The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. Most patients (86.2%) wanted their erectile dysfunction treated, but a minority (31%) had visited a private clinic to discuss the problem. 2) The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The Body Mass Index (BMI) and serum albumin were inversely related to erectile dysfunction. 3) The erectile dysfunction was significantly associated with diabetic autonomic neuropathy and retinopathy. 4) The score from the questionaires of five relevant domains of sexual function (these being, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) were lower in the erectile dysfunctional group. 5) 18 patients were prescribed sildenafil, 61.6% of which reported improved erections by the end of the study, with 50% of these being satisfied with their erections. There were no side effects causing discontinuation of treatment.
CONCLUSION
The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The BMI and serum albumin were inversely related to erectile dysfunction. The effect of sildenafil was simillar to that reported previously for other countries, and was effective in the treatment of erectile dysfunction in type 2 diabetics.