title: Erectile dysfunction is a strong predictor of poor quality of life in men with Type 2 diabetes mellitus.
abstract: OBJECTIVE
  To identify predictors of poor quality of life among men with diabetes from a comprehensive set of sexual, clinical, socio-economic and lifestyle variables.
  
  
  METHODS
  This was a cross-sectional observational-study of 253 men with Type 2 diabetes, randomly selected from a clinic in Colombo, Sri Lanka. Erectile dysfunction was assessed using the five-item International Index of Erectile Function and quality of life was assessed using the Sri Lankan version of the 36-item short form health survey questionnaire and the disease-specific Psychological Impact of Erectile Dysfunction scale. The presence of premature ejaculation, reduced libido, socio-demographic and lifestyle data was obtained using an interviewer-administered questionnaire. Significant predictors of quality of life were identified by stepwise multivariate linear regression models for short form-36 subscales, summary scales and two scales of Psychological Impact of Erectile Dysfunction.
  
  
  RESULTS
  Significant predictors on the physical summary scale of the 36-item short form were erectile dysfunction (β = 7.93, 95% CI 3.70-12.17, P < 0.001) and reduced libido (β = 5.20, 95% CI 0.82-9.59, P < 0.05). Predictors on the mental health summary scale of the 36-item short form were erectile dysfunction (β = 5.82, 95% CI 2.26-9.37, P < 0.01), BMI > 27.5 kg/m(2) (β = 9.12, 95% CI 1.38-17.44, P < 0.05), ischaemic heart disease (β = 6.39, 95% CI 0.74-12.04, P < 0.05) and insulin therapy (β = 5.28, 95% CI 0.34-10.22, P < 0.05). Significant predictors in the sexual experience scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 6.57, 95% CI 4.63-8.51, P < 0.001), reduced libido (β =4.33, 95% CI 2.34-6.32, P < 0.001) and postural hypotension (β = 3.99, 95% CI 0.13-7.85, P < 0.05). Predictors on the emotional life scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 2.96, 95% CI 1.37-4.58, P < 0.001), reduced libido 2.75 (β = 2.75, 95% CI 1.12-4.40, P < 0.01), younger age (β = 1.05, 95% CI 0.35-1.75, P < 0.01) and postural hypotension (β = 3.39, 95% CI 0.35-6.45, P < 0.05).
  
  
  CONCLUSIONS
  Erectile dysfunction was a strong predictor of poor generic and disease-specific quality of life among other sexual and clinical variables in men with diabetes.
authors.affiliation: Oxford Centre for Diabetes, Endocrinology and Metabolism, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
authors.forename: L S
authors.initials: LS
authors.lastname: Malavige
authors.forename: S D
authors.initials: SD
authors.lastname: Jayaratne
authors.forename: S T
authors.initials: ST
authors.lastname: Kathriarachchi
authors.forename: S
authors.initials: S
authors.lastname: Sivayogan
authors.forename: P
authors.initials: P
authors.lastname: Ranasinghe
authors.forename: J C
authors.initials: JC
authors.lastname: Levy
mesh_terms: D000342:Affective Symptoms / Q000523:psychology; D000367:Age Factors; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D004542:Ejaculation / Q000502:physiology; D007172:Erectile Dysfunction / Q000523:psychology*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000523:psychology; D007989:Libido; D008019:Life Style; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*