Sexual function in young women with type 1 diabetes: the METRO study.
OBJECTIVE
The aim of this study was to evaluate the prevalence and risk factors associated with female sexual dysfunction (FSD) in young women with type 1 diabetes treated with different intensive insulin regimens.


METHODS
Type 1 diabetic women aged 18-35 years were included in this study if they had stable couple relationship and no oral contraceptive use. All women were asked to complete the Female Sexual Function Index (FSFI) and other validated multiple-choice questionnaires assessing sexual-related distress (Female Sexual Distress Scale, FSDS), quality of life (SF-36 Health Survey), physical activity (International Physical Activity Questionnaire), depressive symptoms (Zung Self-Rating Depression Scale, SRDS) and diabetes-related problems (Diabetes Integration Scale ATT-19). FSD was diagnosed according to a FSFI score higher than 26.55 and a FSDS score lower than 15.


RESULTS
The overall prevalence of FSD in diabetic and control women was 20 and 15 %, respectively (P = 0.446). Compared with the continuous subcutaneous insulin infusion group and control women, diabetic women on multiple daily injections (MDI) had lower global FSFI score (P = 0.007), FSDS score (P = 0.045) and domains such as arousal (P = 0.006), lubrication and satisfaction scores (P < 0.001 for both). In the multiple regression analysis, only the mental component summary (P = 0.047) and the SRDS score (P = 0.042) were independent predictors of FSFI score in the overall diabetic women.


CONCLUSIONS
Young women with type 1 diabetes wearing an insulin pump show a prevalence of sexual dysfunction similar to that of healthy age-matched women, but sexual function was significantly impaired in diabetic women on MDI therapy. Depression and the mental health status were independent predictors for FSD in diabetic women.
Diabetes Unit, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy. mariaida.maiorino@unina2.it.
M I
MI
Maiorino
Diabetes Unit, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.
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Bellastella
Diabetes Unit, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.
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F
Castaldo
Diabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.
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M
Petrizzo
Diabetes Unit, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.
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D
Giugliano
Diabetes Unit, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.|Diabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Piazza L. Miraglia no 2, 80138, Naples, Italy.
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Esposito
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
Continuous subcutaneous insulin infusion; Female sexual dysfunction; Female sexual function index; Multiple daily insulin injections; Type 1 diabetes