title: Longitudinal assessment of quality of life in patients with type 2 diabetes and self-reported erectile dysfunction.
abstract: OBJECTIVE
  In the context of the QuED (Quality of Care and Outcomes in Type 2 Diabetes) project, we evaluated the longitudinal changes over 3 years in quality of life (QoL) in patients with type 2 diabetes according to the presence or the development of erectile dysfunction (ED).
  
  
  METHODS
  Patients were requested to fill in a questionnaire investigating the presence of ED and QoL (SF-36 Health Survey, depression symptoms [Center for Epidemiologic Studies-Depression], and quality of sexual life) every 6 months for 3 years. The analyses were based on multilevel models, adjusted for patient clinical and sociodemographic characteristics.
  
  
  RESULTS
  The study involved 1,456 patients, of whom 34% reported frequent erectile problems at baseline; 192 developed ED during the follow-up. No changes in QoL measures were detected in patients without ED; in those with ED at baseline, a worsening in all SF-36 scales was observed, reaching statistical significance for physical functioning (P = 0.03). Among patients who developed ED during the study, a deterioration in all SF-36 dimensions and a worsening in depressive symptoms preceded the development of ED. The onset of ED was associated with a further marked worsening in physical functioning (P = 0.0008), general health perception (P = 0.02), and social functioning (P = 0.04) on SF-36 subscales, as well as in the summary physical and mental components scores (P = 0.04 and P = 0.07, respectively). The development of ED was also associated with a highly significant increase in depressive symptoms (P = 0.001) and a marked decrease in quality of sexual life (P < 0.0001).
  
  
  CONCLUSIONS
  This longitudinal study documents for the first time the impact of ED onset on several aspects of QoL in patients with type 2 diabetes. The study also shows that QoL tended to further decrease during 3 years in patients with ED at baseline but not in those without this condition.
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: De Berardis
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegrini
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: Maria C E
authors.initials: MC
authors.lastname: Rossi
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; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology*; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors