Clinical and epidemiological characteristics of sexual dysfunction in men with type 2 diabetes mellitus

• Dmitry I. Esaulenko
• Roman V. Rozhivanov
• Viktoria V. Shishkina

Abstract

Sexual dysfunction is widespread among patients with type 2 diabetes mellitus (T2DM), but the clinical and epidemiological data on them vary depending on sampling. In our study, the results were obtained on a representative sample of a large region of Russia.

The aim - to evaluate the clinical and epidemiological characteristics of sexual dysfunction in male patients with T2DM.

Material and methods. A continuous, cross-sectional, non-interventional screening study included 200 men with T2DM, aged 57 (44; 63) years. The study period was from February to May 2021. A sexology survey was conducted using the International Erectile Function Index (IEFI, %) questionnaire, hemoglobin A1c level, total blood testosterone, and pharmacodopplerography of penis vessels (for patients with erectile dysfunction). The groups were compared using the Mann-Whitney test. The differences were considered statistically significant at p<0.05.

Results. Prevalence of decreased libido - 72%, erectile dysfunction (ED) - 68%, delayed ejaculation -17%, premature ejaculation - 14%, retrograde ejaculation - 2%, infertility - 5%. When comparing the level of total testosterone in patients with low sexual desire and without it, statistically significant differences were found - 7.1 (5.1; 11.9) vs 12.6 (10.9; 15.8) nmol/l, respectively, p<0.001. HbA1c levels were higher in patients with low libido - 9.5 (8.3; 12.7) vs 8.1 (6.9; 10.5)%, respectively, p<0.001. ED was mainly represented by medium-heavy forms. HbA1c levels were higher in patients with ED - 10.6 (9.8; 13.0) vs 8.5 (7.7; 11.3)%, respectively, p<0.001. Carbohydrate metabolism compensation rates in patients with delayed ejaculation were statistically significantly worse than in male patients without this disorder - HbA1c 10.4 (9.1; 13.2) vs 8.7 (7.0; 9.4)%, p=0.006. Patients with premature and retrograde ejaculation had no correlation with carbohydrate metabolism. Of the entire sample of patients, 8% were actively seeking medical advice. A characteristic feature of these men was a normal testosterone level of 14.1 (12.8; 16.7) nmol/l and no low sexual desire.

Conclusion. Males with T2DM are characterized by a high prevalence of sexual disorders associated with decompensation of carbohydrate metabolism and the duration of diabetes. Hypogonadism makes a significant contribution to their progression, which, due to a decreased libido, makes it difficult to detect clinical disorders and requires the implementation of screening programs.

Keywords:males, testosterone, diabetes mellitus, erectile dysfunction, decreased libido

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