New research highlights that 65.8% of diabetic men suffer from erectile dysfunction. Early detection and better diabetes control are key to reducing this common yet serious condition.
Study: The global burden of erectile dysfunction and its associated risk factors in diabetic patients: an umbrella reviews. 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 its associated risk factors.
How does diabetes affect ED risk?
An erection is considered essential for having complete penetrative intercourse. ED is characterized by a consistent inability to obtain 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 throughout the world, it is crucial to investigate the different factors that may impact an individual’s risk of developing ID. For example, increasing ED rates have been associated with several chronic conditions, including cardiovascular disease (CVD), diabetes mellitus (DM), and depression.
In diabetes, high blood sugar levels may cause endothelial dysfunction, which damages blood vessels. Furthermore, increased accumulation of harmful sugar byproducts, elevated cell waste, damage from oxidative stress, and neuropathy also arise due to chronic diabetes. Taken together, these conditions can negatively impact regular erectile response linked to achieving or maintaining an erection.
Diabetes causes peripheral and autonomic nerve damage, which also contributes to the manifestation of ED. In peripheral neuropathy, signals between the penis and brain are dysregulated, which causes difficulties for the body to get stimulated. This condition also restricts blood flow in the penis, which causes problems in maintaining erection.
CVD, including hypertension and atherosclerosis, impairs penile blood flow by restricting proper blood vessel dilation, which results in ED. In fact, ED in diabetic patients may indicate silent heart disease and predict the risk of future cardiovascular events.
The prevalence of ED in diabetic men is high, with current estimates indicating that up to 66% of men with diabetes are affected by ED. Thus, increasing awareness and improving opportunities to discuss this condition is essential, thereby facilitating early detection, treatment, and prevention of long-term consequences.
ED is more than just a physical issue; it can significantly impact a man’s mental and emotional well-being, affecting his confidence, relationships and overall happiness.”
About the study
The current review obtained all relevant information on ED 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 ED prevalence.
A total of 173 articles were initially retrieved from different database search engines. Of these articles, seven met all eligibility criteria of the current umbrella review of systematic review and meta-analysis to estimate the global burden of ED in diabetic patients.
Study findings
The current review included 108,030 male diabetic patients to estimate the global prevalence of ED. The AMSTAR 2 quality assessment tool was used to evaluate the systemic review and meta-analysis. A random effects model was used to assess the pooled prevalence of ED in diabetic men, which was 65.8%.
A prediction interval was constructed to assess the range of potential outcomes if a new study on a similar topic was included. Begg’s and Egger’s tests revealed that no publication bias existed in the studies considered for this umbrella review. The leave-one-out analysis revealed that omitting one study did not significantly influence the overall effect size estimate.
As compared to global ED prevalence, a lower incidence of this condition has been documented in Africa. The associated risk factors of ED among diabetic men were identified to be age above 40 years, DM prevalence greater than ten years, peripheral vascular disease, and body mass index (BMI) above 30 kg/m2.
Variations in study outcomes were attributed to differential underlying study populations and measurement methods. For example, large-scale studies conducted in countries like Ethiopia, India, and Japan included a higher proportion of older diabetic patients, suggesting a greater risk of developing ED.
Conversely, studies conducted in Kuwait and Italy, which included younger and healthier individuals, indicated a lower prevalence of ED. Furthermore, studies using stringent criteria for diagnosing ED reported higher ED prevalence, whereas those with more lenient criteria reported a lower prevalence of ED.
Conclusions
The current umbrella review determined the global prevalence of ED in diabetic patients to be 65.8%, with the pooled prevalence of ED in diabetic patients ranging from 58.3% to 73.3%.
The higher prevalence of ED in diabetic patients emphasizes the importance of routine screening and early diagnosis of this condition. Effective diabetes management may also improve ED conditions, which could positively affect the overall quality of life.
Journal reference:
- Kitaw, T. A., Abate, B. B., Tilahun, B. D., et al. (2024) The global burden of erectile dysfunction and its associated risk factors in diabetic patients: an umbrella reviews. BMC Public Health 24(2816). doi:10.1186/s12889-024-20300-7.