Erectile Dysfunction May Signal Early Diabetes in Some Men

One in five men with new-onset erectile dysfunction (ED) could have unrecognized prediabetes, according to new research in the Journal of Sexual Medicine.

The association between diabetes and ED has been widely reported, but there is less information about a possible link with prediabetes, the authors said. Generally, a person is considered to have prediabetes if his or her blood sugar levels are higher than normal, but not high enough to meet the criteria for a type 2 diabetes diagnosis. Patients with prediabetes aren’t always aware that they have it.

Researchers collected data from 372 white sexually active European men who were seeking help for new-onset ED between January 2013 and September 2017. None of the men had used phosphodiesterase type 5 inhibitors to treat ED.

The men completed the International Index of Erectile Function (IIEF), and fasting glucose measurements were taken. The men were evaluated for comorbidity factors (such as hypertension, smoking habits, alcohol consumption, and body mass index) with the Charlson Comorbidity Index. Cholesterol, triglycerides, testosterone, and sex hormone-binding globulin were also assessed.

Overall, 23% of the men had “clinical criteria suggestive for” prediabetes. This group was more likely to be older, to be obese, and to have comorbid conditions than their counterparts with normal glucose levels. These men also had lower levels of total testosterone, and higher levels of triglycerides and total cholesterol.

“Overall, the set of these findings confirmed the importance of glucose metabolism investigation during every basic work-up for sexual dysfunction,” the authors wrote, adding that diagnosing prediabetes early might decrease the odds of future chronic illness.

Severity of ED appeared to be connected to glucose levels. On the erectile function domain of the IIEF, men in the prediabetes group tended to have lower scores than the men with normal glucose levels, indicating poorer function. However, no differences were found on the other IIEF domains of intercourse satisfaction, sexual desire, orgasmic function, and overall satisfaction.

The authors noted that their study subjects were all white, European men, so the findings might not apply to more diverse groups. In addition, duration of prediabetes and exercise could have influenced the men’s health, but there was no information available for either factor. The lack of a control group was another limitation, they said. 

Resources

 Centers for Disease Control and Prevention

“Prediabetes: Your Chance to Prevent Type 2 Diabetes”

(Page last reviewed: June 25, 2018)

https://www.cdc.gov/diabetes/basics/prediabetes.html

The Journal of Sexual Medicine

Boeri, Luca MD, et al.

“Unrecognized Prediabetes Is Highly Prevalent in Men With Erectile Dysfunction–Results From a Cross-Sectional Study”

(Full-text. August 2018)

https://www.jsm.jsexmed.org/article/S1743-6095(18)31057-9/fulltext

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