Aml Mohamed Nada
Objectives: To find out the frequency of erectile dysfunction in diabetic patients and the association between erectile dysfunction and various clinical and laboratory parameters such as diabetic neuropathy, diabetes control, and cardiovascular risk factors.
Subjects and methods: 91 type 2 diabetic patients were screened for erectile dysfunction. Clinical data were collected and included body mass index (BMI), blood pressure (BP), heart rate, duration of diabetes and diabetes complications mainly peripheral diabetic neuropathy (PDN). Laboratory data included testosterone, pituitary gonadotropins, fasting plasma glucose (FPG), HbA1c, complete blood count (CBC), serum creatinine and lipid profile. Associations of testosterone and erectile dysfunction with various clinical and biochemical parameters were studied.
Results: Erectile dysfunction (ED) was present in 56% of our patients. No significant difference in total testosterone level, LH, FSH or Prolactin level between patients with and those without erectile dysfunction. Patients with peripheral diabetic Neuropathy were significantly at higher risk for erectile dysfunction (ED) [p=0.008]. High HbA1c, Low MPV and low MCH were significant and independent predictors for ED (p= 0.033, 0.033, 0.004 respectively, OR= 1.651, 5.562, 9.524 respectively). Testosterone level was negatively and significantly associated with BMI, heart rate and RDW (p= <0.005, 0.047, 0.028 respectively).
Conclusion:
Erectile dysfunction is very common among type 2 diabetic patients. It is strongly and directly associated with peripheral diabetic neuropathy (PDN) so, questionnaire and patient examination for PDN and further interrogation of patients complaining of PDN for erectile dysfunction (ED) is of utmost significance. This disorder can be easily predicted by the low MPV and low MCV which are found to be independent predictors in our study population. ED in T2DM is not related to serum testosterone level. Proper control of blood glucose and reaching the target HbA1c can protect diabetic patients from development of such disorder as HbA1c is also found to be a significant independent predictor of it.
