Erectile dysfunction in type 2 diabetic men: relationship to exercise fitness and cardiovascular risk factors in the Look AHEAD trial.
BACKGROUND
Determinants of erectile dysfunction in diabetic men have not been adequately investigated as potential mediators of change.


OBJECTIVE
To determine the prevalence and correlates of erectile dysfunction (ED) in overweight men with type 2 diabetes in the multicenter, Look AHEAD trial (Action for Health in Diabetes).


METHODS
International Index of Erectile Function (IIEF), self-reported use of phosphodiesterase type 5 inhibitors, laboratory measures of adiposity, cardiometabolic parameters, and exercise fitness.


METHODS
Male participants aged 45-75 in the Look AHEAD trial in a committed relationship were recruited for an ongoing study of sexual function and diabetes. Eligible participants completed the IIEF questionnaire and provided updated information on use of medical treatments for sexual dysfunction. Baseline sexual function results for participants in the male ancillary study are reported here; intervention data and results for female participants are presented elsewhere.


RESULTS
A total of 373 eligible male participants completed all sexual function questionnaires, of whom 263 (68.7%) were sexually active at the time of the study. Almost half (49.8%) of the men reported mild or moderate degrees of ED, and 24.8% had complete ED. Among sexually active participants, 42.6% had sought medical help for their problem, and 39.7% reported use of ED medications. ED was significantly associated with age (odds ratio [OR] = 1.05; confidence interval [CI]: 1.01-1.10) baseline HbA(1c) (OR = 1.31; CI: 1.05-1.63), hypertension history (OR = 2.41; CI: 1.34-4.36), and metabolic syndrome (OR = 3.05, CI: 1.31-7.11). Of note, cardiorespiratory fitness was found to be protective of ED in a multivariable analysis (OR = 0.61; P < 0.001).


CONCLUSIONS
ED is prevalent in this sample of obese, type 2 diabetic men in the Look AHEAD study. Cardiovascular risk factors were highly associated with ED in this population, and cardiorespiratory fitness was protective in this analysis.
Rosen
Raymond C
RC
New England Research Institutes, 9 Galen Street, Watertown, MA, USA. rrosen@neriscience.com
Wing
Rena R
RR
Schneider
Stephen
S
Wadden
Thomas A
TA
Foster
Gary D
GD
West
Delia Smith
DS
Kitabchi
Abbas E
AE
Brancati
Frederick L
FL
Maschak-Carey
Barbara J
BJ
Bahnson
Judy L
JL
Lewis
Cora E
CE
Gendrano Iii
Isaias N
IN
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D015444:Exercise; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010809:Physical Fitness; D015995:Prevalence; D012307:Risk Factors