title: Sexual function in men with diabetes type 2: association with glycemic control.
abstract: OBJECTIVE
  We evaluated the association of glycemic control with erectile dysfunction in men with diabetes type 2.
  
  
  METHODS
  A convenience sample of men with diabetes type 2 at the Cleveland Veterans Affairs Medical Center completed questions 1 to 5 of the International Index of Erectile Function. The primary outcome measure was erectile function score, calculated as the sum of questions 1 to 5. Details of disease duration, complications, medication use, patient age and level of glycosylated hemoglobin were obtained by reviewing the medical record.
  
  
  RESULTS
  Mean subject age plus or minus standard deviation was 62.0+/-12.3 years, mean hemoglobin A1c was 8.1%+/-1.9% and mean erectile function score was 16.6+/-5.9 (range 5 to 23). Stratified analysis revealed that mean erectile function score decreased as hemoglobin A1c increased (analysis of variance p = 0.002). The test for linearity was also significant (p = 0.001). There were no statistically significant associations of levels of glycemic control with alpha-blocker, beta-blocker or diuretic use. Bivariate analysis showed a significant correlation of hemoglobin A1c with neuropathy but not with patient age, duration of diabetes, alpha-blockers, beta-blockers or diuretics. Multivariate analysis demonstrated that hemoglobin A1c was an independent predictor of erectile function score (p<0.001) even after adjusting for peripheral neuropathy, which was also an independent predictor (p = 0.023).
  
  
  CONCLUSIONS
  Our data add to the growing body of literature suggesting that erectile dysfunction correlates with the level of glycemic control. Peripheral neuropathy and hemoglobin A1c but not patient age were independent predictors of erectile dysfunction.
authors.affiliation: Department of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center and Case Western Reserve University, Ohio 44106-5046, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Romeo
authors.forename: A D
authors.initials: AD
authors.lastname: Seftel
authors.forename: Z T
authors.initials: ZT
authors.lastname: Madhun
authors.forename: D C
authors.initials: DC
authors.lastname: Aron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose