title: Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked.
abstract: 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.
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Via Nazionale, 66030 S. Maria Imbaro, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: De Berardis
authors.forename: Monica
authors.initials: M
authors.lastname: Franciosi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Belfiglio
authors.forename: Barbara
authors.initials: B
authors.lastname: Di Nardo
authors.forename: Sheldon
authors.initials: S
authors.lastname: Greenfield
authors.forename: Sherrie H
authors.initials: SH
authors.lastname: Kaplan
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegrini
authors.forename: Michele
authors.initials: M
authors.lastname: Sacco
authors.forename: Gianni
authors.initials: G
authors.lastname: Tognoni
authors.forename: Miriam
authors.initials: M
authors.lastname: Valentini
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
mesh_terms: 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