Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked.
OBJECTIVE
Within the context of a large, nationwide outcomes research program in type 2 diabetes, we assess the prevalence of self-reported erectile dysfunction and evaluate its impact on quality of life.


METHODS
The study involved 1,460 patients enrolled by 114 diabetes outpatient clinics and 112 general practitioners. Patients were asked to complete a questionnaire investigating their ability to achieve and maintain an erection. Various aspects of quality of life were also assessed depressive using the following instruments: SF-36 Health Survey, diabetes health distress, psychological adaptation to diabetes, depressive symptoms (CES-D scale), and quality of sexual life.


RESULTS
Overall, 34% of the patients reported frequent erectile problems, 24% reported occasional problems, and 42% reported no erectile problems. After adjusting for patient characteristics, erectile dysfunction was associated with higher levels of diabetes-specific health distress and worse psychological adaptation to diabetes, which were, in turn, related to worse metabolic control. Erectile problems were also associated with a dramatic increase in the prevalence of severe depressive symptoms, lower scores in the mental components of the SF-36, and a less satisfactory sexual life. A total of 63% of the patients reported that their physicians had never investigated their sexual problems.


CONCLUSIONS
Erectile dysfunction is extremely common among type 2 diabetic patients and is associated with poorer quality of life, as measured with generic and diabetes-specific instruments. Despite their relevance, sexual problems are seldom investigated by general practitioners and specialists.
De Berardis
Giorgia
G
Department of Clinical Pharmacology and Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Via Nazionale, 66030 S. Maria Imbaro, Italy.
Franciosi
Monica
M
Belfiglio
Maurizio
M
Di Nardo
Barbara
B
Greenfield
Sheldon
S
Kaplan
Sherrie H
SH
Pellegrini
Fabio
F
Sacco
Michele
M
Tognoni
Gianni
G
Valentini
Miriam
M
Nicolucci
Antonio
A
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology*; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D018434:Sickness Impact Profile