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Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?

Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database

¹ Section of Urology, VA Puget Sound Health Care System, and the Department of Urology, University of Washington, Seattle, Washington
² Department of Urology, University of California—San Francisco, San Francisco, California
³ TAP Pharmaceutical Products, Inc., Lake Forest, Illinois

OBJECTIVE—Little is known regarding how diabetic men with erectile dysfunction (ED) differ from the general population of impotent men. The primary objective of this study was to compare disease-specific health-related quality of life (HRQOL) and severity of ED in impotent men with and without diabetes.

RESEARCH DESIGN AND METHODS—Validated functional and HRQOL questionnaires (including the International Index of Erectile Function, the Sexual Self-Efficacy Scale, and the Psychological Impact of Erectile Dysfunction scales) were administered to patients in an ED disease registry. Men with ED and a history of diabetes (n = 20) were compared with men with ED and no history of diabetes (n = 90) at baseline and at the 12-month follow-up.

RESULTS—Diabetic impotent men reported worse erectile function and intercourse satisfaction at baseline, and ED had a greater impact on their emotional life. Diabetic men with ED had significantly different trends over time in the Erectile Function (P < 0.001), Intercourse Satisfaction (P < 0.013), Sexual Desire (P < 0.016), Overall Satisfaction (P < 0.023), and the Sexual Experience-Psychological Impact domains (P < 0.002). In addition, there was a trend toward a difference over time in the Emotional Life-Psychological Impact domain (P < 0.067).

CONCLUSIONS—Impotent men with diabetes present with worse ED than nondiabetic men with ED, resulting in worse disease-specific HRQOL in the diabetic men. Although diabetic patients initially respond well to ED treatment, responses do not appear to be durable over time. Therefore, clinicians must provide longer-term follow-up when treating ED in diabetic patients.

Abbreviations: ED, erectile dysfunction • ExCEED, Exploratory Comprehensive Evaluation of Erectile Dysfunction • HRQOL, health-related quality of life • IIEF, International Index of Erectile Function • PIED, Psychological Impact of Erectile Dysfunction • VA, Veterans Administration

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