title: Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes: a national, population-based study.
abstract: OBJECTIVE
  To describe sexual activity, behavior, and problems among middle-age and older adults by diabetes status.
  
  
  METHODS
  This was a substudy of 1,993 community-residing adults, aged 57-85 years, from a cross-sectional, nationally representative sample (N = 3,005). In-home interviews, observed medications, and A1C were used to stratify by diagnosed diabetes, undiagnosed diabetes, or no diabetes. Logistic regression was used to model associations between diabetes conditions and sexual characteristics, separately by gender.
  
  
  RESULTS
  The survey response rate was 75.5%. More than 60% of partnered individuals with diagnosed diabetes were sexually active. Women with diagnosed diabetes were less likely than men with diagnosed diabetes (adjusted odds ratio 0.28 [95% CI 0.16-0.49]) and other women (0.63 [0.45-0.87]) to be sexually active. Partnered sexual behaviors did not differ by gender or diabetes status. The prevalence of orgasm problems was similarly elevated among men with diagnosed and undiagnosed diabetes compared with that for other men, but erectile difficulties were elevated only among men with diagnosed diabetes (2.51 [1.53 to 4.14]). Women with undiagnosed diabetes were less likely to have discussed sex with a physician (11%) than women with diagnosed diabetes (19%) and men with undiagnosed (28%) or diagnosed (47%) diabetes.
  
  
  CONCLUSIONS
  Many middle-age and older adults with diabetes are sexually active and engage in sexual behaviors similarly to individuals without diabetes. Women with diabetes were more likely than men to cease all sexual activity. Older women with diabetes are as likely to have sexual problems but are significantly less likely than men to discuss them.
authors.affiliation: Department of Obstetrics and Gynecology, Program for Integrative Sexual Medicine, University of Chicago, Chicago, Illinois, USA. slindau@uchicago.edu
authors.forename: Stacy Tessler
authors.initials: ST
authors.lastname: Lindau
authors.forename: Hui
authors.initials: H
authors.lastname: Tang
authors.forename: Ada
authors.initials: A
authors.lastname: Gomero
authors.forename: Anusha
authors.initials: A
authors.lastname: Vable
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Drum
authors.forename: Dima M
authors.initials: DM
authors.lastname: Qato
authors.forename: Marshall H
authors.initials: MH
authors.lastname: Chin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000502:physiology*
references.citation: Diabetes Care. 2009 Dec;32(12):e141-7
references.pmid: 19940210
references.citation: JAMA. 1963 Sep 21;185:914-9
references.pmid: 14044222
references.citation: Diabetes Care. 2009 Feb;32(2):287-94
references.pmid: 19017771
references.citation: J Am Geriatr Soc. 2004 Jan;52(1):117-22
references.pmid: 14687325
references.citation: J Gerontol B Psychol Sci Soc Sci. 2009 Nov;64 Suppl 1:i131-6
references.pmid: 19244547
references.citation: J Psychosoc Nurs Ment Health Serv. 2007 Feb;45(2):24-32
references.pmid: 17334200
references.citation: J Gerontol B Psychol Sci Soc Sci. 2009 Nov;64 Suppl 1:i86-93
references.pmid: 19491196
references.citation: J Gerontol B Psychol Sci Soc Sci. 2009 Nov;64 Suppl 1:i12-9
references.pmid: 19567827
references.citation: Diabetes Care. 2007 Sep;30(9):2233-5
references.pmid: 17563338
references.citation: J Urol. 2000 Mar;163(3):788-91
references.pmid: 10687978
references.citation: Nurs Res. 2002 Jan-Feb;51(1):18-25
references.pmid: 11822565
references.citation: Diabetes Care. 2009 Jul;32(7):1327-34
references.pmid: 19502545
references.citation: J Aging Health. 1993 May;5(2):179-93
references.pmid: 10125443
references.citation: Med Care. 1996 Jan;34(1):73-84
references.pmid: 8551813
references.citation: Sex Transm Infect. 2001 Apr;77(2):84-92
references.pmid: 11287683
references.citation: J Sex Med. 2004 Jul;1(1):6-23
references.pmid: 16422979
references.citation: N Engl J Med. 2007 Aug 23;357(8):762-74
references.pmid: 17715410
references.citation: Ann Intern Med. 1993 Feb 1;118(3):201-10
references.pmid: 8417638
references.citation: Diabet Med. 1998 Oct;15(10):809-15
references.pmid: 9796879
references.citation: Lancet. 2007 Feb 17;369(9561):597-611
references.pmid: 17307107