Longitudinal Assessment of Quality of Life in Patients With Type 2 Diabetes and Self-Reported Erectile Dysfunction
- Giorgia De Berardis, MSCPHARMCHEM,
- Fabio Pellegrini, MSCSTAT,
- Monica Franciosi, MSCBIOLS,
- Maurizio Belfiglio, MD,
- Barbara Di Nardo, HSDIP,
- Sheldon Greenfield, MD,
- Sherrie H. Kaplan, PHD, MPH,
- Maria C.E. Rossi, MSCPHARMCHEM,
- Michele Sacco, MD,
- Gianni Tognoni, MD,
- Miriam Valentini, MD,
- Antonio Nicolucci, MD and
- on behalf of the QuED (Quality of Care and Outcomes in Type 2 Diabetes) Study Group*
- Address correspondence and reprint requests to Antonio Nicolucci, MD, Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/A, 66030 S. Maria Imbaro (CH), Italy. E-mail: nicolucci{at}negrisud.it
Abstract
OBJECTIVE—In the context of the QuED (Quality of Care and Outcomes in Type 2 Diabetes) project, we evaluated the longitudinal changes over 3 years in quality of life (QoL) in patients with type 2 diabetes according to the presence or the development of erectile dysfunction (ED).
RESEARCH DESIGN AND METHODS—Patients were requested to fill in a questionnaire investigating the presence of ED and QoL (SF-36 Health Survey, depression symptoms [Center for Epidemiologic Studies–Depression], and quality of sexual life) every 6 months for 3 years. The analyses were based on multilevel models, adjusted for patient clinical and sociodemographic characteristics.
RESULTS—The study involved 1,456 patients, of whom 34% reported frequent erectile problems at baseline; 192 developed ED during the follow-up. No changes in QoL measures were detected in patients without ED; in those with ED at baseline, a worsening in all SF-36 scales was observed, reaching statistical significance for physical functioning (P = 0.03). Among patients who developed ED during the study, a deterioration in all SF-36 dimensions and a worsening in depressive symptoms preceded the development of ED. The onset of ED was associated with a further marked worsening in physical functioning (P = 0.0008), general health perception (P = 0.02), and social functioning (P = 0.04) on SF-36 subscales, as well as in the summary physical and mental components scores (P = 0.04 and P = 0.07, respectively). The development of ED was also associated with a highly significant increase in depressive symptoms (P = 0.001) and a marked decrease in quality of sexual life (P < 0.0001).
CONCLUSIONS—This longitudinal study documents for the first time the impact of ED onset on several aspects of QoL in patients with type 2 diabetes. The study also shows that QoL tended to further decrease during 3 years in patients with ED at baseline but not in those without this condition.
- CES-D, Center for Epidemiologic Studies–Depression
- CVD, cardiovascular disease
- ED, erectile dysfunction
- QoL, quality of life
- TIBI, Total Illness Burden Index
Footnotes
- *
↵* A complete list of QuED Study Group investigators can be found in the appendix.
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted July 29, 2005.
- Received March 31, 2005.
- DIABETES CARE
