title: Association of type and duration of diabetes with erectile dysfunction in a large cohort of men.
abstract: OBJECTIVE
  Differences in risk of erectile dysfunction (ED) by characteristics of diabetes among older men are not well understood. We examined the association of type and duration of diabetes with erectile function in men >50 years of age in a large prospective cohort study.
  
  
  METHODS
  Subjects included 31,027 men aged 53-90 years in the Health Professionals Follow-Up Study cohort. On a questionnaire mailed in 2000, participants rated their ability (without treatment) in the past 5 years to have and maintain an erection sufficient for intercourse. Men who reported poor or very poor function were considered to have ED. Diabetes information was ascertained via self-report and documented with supplementary medical data.
  
  
  RESULTS
  Men with diabetes had an age-adjusted relative risk (RR) of 1.32 (95% CI 1.3-1.4) for having ED compared with men without diabetes. In multivariable regression analyses, men with type 1 and type 2 diabetes were at a significantly higher risk for ED (type 1 diabetes RR = 3.0, 95% CI 1.5-5.9; type 2 diabetes RR = 1.3, 1.1-1.5) than nondiabetic men. Men with type 2 diabetes had an increasingly greater risk of ED with increased duration since diagnosis (trend test P value <0.0001) (RR = 1.7, 95% CI 1.1-2.7, for men diagnosed >20 years previously).
  
  
  CONCLUSIONS
  For men over age 50 years, increasing duration of diabetes was positively associated with increased risk of ED relative to nondiabetic subjects. This association persisted despite the higher prevalence of other comorbid conditions. ED prevention and diabetes management efforts are likely to go hand-in-hand.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
authors.forename: Constance G
authors.initials: CG
authors.lastname: Bacon
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Dale B
authors.initials: DB
authors.lastname: Glasser
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
mesh_terms: D017677:Age Distribution; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis