Key Global Literature

De Angelis L, Marfella MA, Siniscalchi M, Marino L, Nappo F, Giugliano F, De Lucia D, Giugliano D: Erectile and endothelial dysfunction in type II diabetes: a possible link. Diabetologia 44:1155–1160, 2001

Findings. De Angelis et al. studied type 2 diabetic patients with symptomatic erectile dysfunction (ED) and control diabetic patients matched for age and disease without ED. Endothelial functions (using biochemical markers), hemostasis and fibrinolysis, and quantitative testing to assess peripheral or autonomic neuropathy were studied. There was a significant relation between HbA_1c and erectile function score in patients with ED (r = −0.45). The decrease in blood pressure and platelet aggregation in response to l-arginine was lower in patients with ED, whereas soluble thrombomodulin, P-selectin, and intercellular cell ahhesion molecule-1 concentrations were higher. Indices of coagulation activation (F1 + 2 and d-dimers) and reduced fibrinolysis (plasmingen-activated inhibitor-1) were also found to be higher in ED patients. Heat-pain and warm perception thresholds, as well as cardiovascular reflex tests, were most commonly abnormal in patients with ED.

Significance. The aim of this study was to evaluate the relation between ED and endothelial functions, coagulation activation, and peripheral and autonomic neuropathy in men with type 2 diabetes. ED in diabetic men correlated with endothelial dysfunction. The authors suggest that reduced nitric oxide activity might provide a unifying explanation, although this was not actually measured in the study.

Clinical Impact. Unfortunately, the two groups of patients in this study were not matched for glycemic …