New research highlights that 65.8% of diabetic men suffer from erectile dysfunction. Early detection and better control of diabetes is the key to reducing this common but serious condition.
Study: The global burden of erectile dysfunction and associated risk factors in diabetic patients: an umbrella review. Image credit: PeopleImages.com / Yuri A / Shutterstock.com
A recent study published in BMC Public Health reviews the current burden of erectile dysfunction (ED) in diabetic men and associated risk factors.
How does diabetes affect ED risk?
An erection is considered necessary for full penetrative intercourse. ED is characterized by a persistent inability to achieve or maintain an erection for sexual satisfaction.
Several studies have reported that ED affects a man’s physical, mental and emotional well-being. Thus, considering the increasing rates of ED worldwide, it is vital to investigate the various factors that may influence an individual’s risk of developing ED. For example, increasing rates of ED have been associated with several chronic conditions, including cardiovascular disease (CVD), diabetes mellitus (DM), and depression.
In diabetes, high blood sugar levels can cause endothelial dysfunction, which damages blood vessels. In addition, increased accumulation of harmful sugar byproducts, increased cellular waste, oxidative stress damage, and neuropathy also result from chronic diabetes. Taken together, these conditions can negatively affect the regular erectile response associated with achieving or maintaining an erection.
Diabetes mellitus causes peripheral and autonomic nerve damage, which also contributes to ED. In peripheral neuropathy, the signals between the penis and the brain are dysregulated, which causes difficulties for the body to stimulate. This condition also restricts blood flow to the penis, which causes problems in maintaining an erection.
Cardiovascular disease, including hypertension and atherosclerosis, impairs penile blood flow by limiting proper blood vessel dilation, which leads to DM. In fact, DM in diabetic patients may indicate latent heart disease and predict the risk of future cardiovascular events.
The prevalence of DM in diabetic men is high, with current estimates suggesting that up to 66% of men with diabetes are affected by DM. Therefore, raising awareness and improving opportunities to discuss this condition is essential, thus facilitating early detection, treatment and prevention of long-term consequences.
ED is more than just a physical issue. can significantly affect a man’s mental and emotional well-being, affecting his confidence, relationships and overall happiness.”
About the study
The current review collected all relevant information on DM in diabetic patients from PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, Embase and Google Scholar. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of ED.
A total of 173 articles were initially retrieved from different database search engines. Of these articles, seven met all eligibility criteria of the current general review of the systematic review and meta-analysis to estimate the global burden of DM in diabetic patients.
Study findings
The current review included 108,030 male diabetic patients to estimate the global prevalence of DM. The AMSTAR 2 quality assessment tool was used to assess the systematic review and meta-analysis. A random-effects model was used to assess the pooled prevalence of DM in diabetic men, which was 65.8%.
A prediction interval was created to assess the range of possible results if a new study on a similar topic were included. Begg and Egger’s tests revealed that there was no publication bias in the studies considered for this umbrella review. Attrition analysis revealed that omitting a study did not significantly affect the overall effect size estimate.
Compared to the global prevalence of DM, a lower incidence of this condition has been documented in Africa. Associated risk factors for DM among diabetic men were identified to be age older than 40 years, DM prevalence greater than ten years, peripheral vascular disease, and body mass index (BMI) greater than 30 kg/m2.
Variations in study results were attributed to different study subject populations and measurement methods. For example, large-scale studies conducted in countries such as Ethiopia, India, and Japan included a higher proportion of elderly diabetic patients, suggesting a greater risk of developing DM.
In contrast, studies conducted in Kuwait and Italy, which included younger and healthier subjects, showed a lower prevalence of DM. Furthermore, studies using strict criteria for the diagnosis of DM reported a higher prevalence of DM, while those with more lenient criteria reported a lower prevalence of DM.
conclusions
The current umbrella review determined the global prevalence of DM in diabetic patients to be 65.8%, with the pooled prevalence of DM in diabetic patients ranging from 58.3% to 73.3%.
The higher prevalence of DM in diabetic patients highlights the importance of regular routine screening and early diagnosis of this condition. Effective diabetes management can also improve DM conditions, which could positively impact overall quality of life.
Journal Reference:
- Kitaw, TA, Abate, BB, Tilahun, BD, et al. (2024) The global burden of erectile dysfunction and associated risk factors in diabetic patients: an umbrella review. BMC Public Health 24(2816). doi:10.1186/s12889-024-20300-7.
