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Managing erectile dysfunction in people with diabetes

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Erectile dysfunction is a common problem in diabet Erectile dysfunction is a common problem in diabetes increasing with age, duration and severity of the disease

Erectile dysfunction (ED) is a common and clinically significant problem in men with diabetes. In addition to the impact on sexual function, ED has longer term psychological and cardiovascular implications. Relationships may suffer and quality of life can be reduced.

This article considers the prevalence, underlying pathology and consequences of ED in men with diabetes. Essential points in history-taking and relevant examination and investigations are discussed before addressing management of ED.

A widely accepted functional definition of ED is ‘the persistent inability to attain and/or maintain an erection sufficient to permit satisfactory sexual performance’.1

How common is erectile dysfunction in men with diabetes?

Estimates of prevalence of ED in men with diabetes varies widely, between 25% and 75% quoted in one review, according to the definition of ED used, the age cohort, the length of time with diabetes and the level of glycaemic control.2 A recent meta-analysis identified a prevalence of ED of 52.5% in men with diabetes, higher for type 2 diabetes (T2DM) than type 1 diabetes (T1DM) and 3.5 times that of an age-matched control population.3

Thus, ED is a common problem in diabetes increasing with age, duration and severity of the disease. The data would support screening for ED in men with diabetes, allowing effective management at an earlier stage in its trajectory.

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