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Clinical, Socioeconomic, and Lifestyle Parameters Associated With Erectile Dysfunction Among Diabetic Men

¹ Unit of Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
² Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
³ Diabetes Unit, Wolfson Medical Center, Holon, Israel
⁴ Information and Computer Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
⁵ Department of Internal Medicine C and the Diabetes Unit, Soroka University Medical Center, Beer-Sheba, Israel
⁶ Unit of Biostatistics, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
⁷ Diabetes Unit, Hadasa Medical Center, Jerusalem, Israel

Address correspondence and reprint requests to Ofra Kalter-Leibovici, Unit of Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, 52621, Israel. E-mail: ofrak{at}post.tau.ac.il

OBJECTIVE—Erectile dysfunction is frequently observed in diabetes. The current study aims to assess the association of a comprehensive set of clinical, socioeconomic, and lifestyle parameters with erectile dysfunction in diabetic men.

RESEARCH DESIGN AND METHODS—Participants were randomly selected from male patients (age >18 years) treated in 26 diabetes clinics in Israel. Participants completed a self-reported questionnaire on demographic, socioeconomic, and lifestyle characteristics and on erectile function, using the IIEF-15 (International Index of Erectile Function). Information on diabetes type, duration, treatment, and control; microvascular complications and cardiovascular disease; drug therapy; blood pressure; and lipid levels was also obtained.

RESULTS—Information on erectile function was obtained in 1,040 patients. Their mean age was 57 years, and their median diabetes duration was 8 years (range <1–50). Normal erectile function was found in 13.5% of the patients and severe erectile dysfunction in 30.1%. The characteristics found to be significantly associated with erectile dysfunction [associations presented as adjusted odds ratio (95% CI)] were: patient’s age (5-year increments): 1.38 (1.29–1.48); diabetes duration (5-year increments): 1.16 (1.07–1.26); current HbA_1c level (1% increment): 1.10 (1.01–1.19); any microvascular disease: 1.43 (1.09–1.88); cardiovascular disease: 1.78 (1.27–2.48); and diuretic treatment: 1.78 (1.09–2.91). Leisure time and work-related physical activity and consumption of small amounts of alcohol were found to be protective: 0.51 (0.36–0.72) and 0.70 (0.51–0.97), respectively.

CONCLUSIONS—In diabetic men, erectile dysfunction severity increases with age and diabetes duration, poor glycemic control, presence of microvascular complications, diuretic treatment, and cardiovascular disease. Physical activity and alcohol intake may be protective. These findings can guide clinicians in taking preventive measures and undertaking early screening and treatment in high-risk patients.

Abbreviations: CVD, cardiovascular disease

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