An “integrated approach” in of treatment men with type 2 diabetes could result in better sexual function and less depression, according to new research by a team of Italian researchers.
Erectile dysfunction (ED) is a common problem for diabetic men and can be a marker for cardiovascular disease, too. However, erectile function isn’t always assessed in clinical settings, the study authors noted. Men with ED may not feel comfortable discussing it with their healthcare provider. And providers may not address it either.
This study, which involved diabetes care centers in Italy, was conducted in two phases. Men’s sexual function was assessed at baseline (phase 1) and again after a follow-up period (phase 2, which had a mean duration of 18 months).
Four hundred ninety-three men participated in the first phase. Of these, 450 men with an average age of 59 went on to phase 2.
The men completed the International Index of Erectile Function (IIEF), a questionnaire designed to assess men’s sexual health. They were also evaluated for depression and low testosterone. Each man had a complete physical exam as well.
At baseline, 18% of the men were not sexually active and about 48% of the men reported some degree of ED. At phase 2, 14% were not having sex and 42% had ED.
When the sexually inactive men were taken out of the calculations, 59% of the men had ED at baseline. This percentage dropped to 48% at phase 2.
Between the two phases, 38% of the men took ED medications. Sildenafil was the most common drug taken at baseline, vardenafil at follow-up.
Depressive symptoms generally decreased between phase 1 and phase 2. In addition, the men saw improvements in “metabolic targets,” especially lipid profiles. This result may have stemmed from the use of statins. Testosterone levels and body mass index (BMI) also improved.
The authors pointed out the importance of sexual activity for overall health, cardiovascular health, and stress reduction. They suggested that diabetic men might be more inclined to keep their diabetes under control if they know of their risk for ED and heart disease.
They also called for greater patient involvement in ED treatment plans, along with appropriate counseling and follow-up. “Poor adherence to treatment with [phosphodiesterase type 5 inhibitors – ED drugs] may be partially explained by the inability of physicians to tailor the treatment to the patient’s needs, which highlights inaccurate drug selection,” they wrote.
“Moreover, pharmacological treatment alone does not resolve the many different problems manifesting in ED, including anxiety, loss of self-esteem, depressed mood, poor communication between the couple or the partner’s sexual dysfunction,” they added.
The study was published online in October in PLOS One.
Resources
PLOS One
Corona, Giovanni, et al.
“Sexual Dysfunction in Type 2 Diabetes at Diagnosis: Progression over Time and Drug and Non-Drug Correlated Factors”
(Full-text. Published: October 5, 2016)
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157915