DIABETES-RELATED SEXUAL DYSFUNCTION AND ITS ASSOCIATION WITH MICROVASCULAR COMPLICATIONS: A STUDY FROM TERTIARY CARE CENTER IN SOUTH KERALA

AJAY PAUL; ATHULYA G. ASOKAN

doi:10.22159/ajpcr.2024.v17i5.49025

Authors

AJAY PAUL Department of General Medicine, Dr. Moopens Medical College, Wayanad, Kerala, India https://orcid.org/0009-0009-0626-3235
ATHULYA G. ASOKAN Department of General Medicine, Government Medical College, Kottayam, Kerala, India. https://orcid.org/0000-0001-9146-9717

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i5.49025

Keywords:

Type 2 diabetes, Sexual dysfunction, Erectile dysfunction, Microvascular complications, Glycemic status

Abstract

Objectives: (1) The objective of this study was to determine the frequency of sexual dysfunction (SD) among patients with Type 2 diabetes mellitus attending the General Medicine and Endocrinology Department at a tertiary care center in south Kerala. (2) To assess the relationship between erectile dysfunction and the microvascular consequences of Type 2 diabetes. (3) To correlate SD with glycemic status.

Methods: One hundred and twenty patients with Type 2 diabetes at a tertiary care center in south Kerala participated in the cross-sectional study. A questionnaire was employed to document demographic and glycemic status. The assessment tools utilized included the International Index of Erectile Function for male and the Female Sexual Function Index (FSFI) scoring questionnaire for females. The statistical analysis employed included unpaired t-tests for students and tests assessing the equality of proportions.

Results: About 65% of patients with diabetes mellitus had SD. About 46% of female participants and 78.6% of male participants in the study population had SD. Duration of diabetes, poor glycemic status, and microvascular complications correlated with SD.

Conclusion: SD is frequent in patients with Type 2 diabetes mellitus. Glycemic control determines the development of SD. It is advisable to screen patients with Type 2 diabetes mellitus for SD as a proactive measure for early intervention and management.

Downloads

Download data is not yet available.

Author Biography

AJAY PAUL, Department of General Medicine, Dr. Moopens Medical College, Wayanad, Kerala, India

References

Tao Z, Shi A, Zhao J. Epidemiological perspectives of diabetes. Cell Biochem Biophys. 2015;73(1):181-5. doi: 10.1007/s12013-015- 0598-4, PMID 25711186

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53. doi: 10.2337/diacare.27.5.1047, PMID 15111519

Rahman S, Rahman T, Ismail AA, Rashid AR. Diabetes-associated macrovasculopathy: Pathophysiology and pathogenesis. Diabetes Obes Metab. 2007;9(6):767-80. doi: 10.1111/j.1463-1326.2006.00655.x, PMID 17924861

Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95-105. doi: 10.2147/DMSO.S36455, PMID 24623985

Shindel AW, Lue TF. Sexual dysfunction in diabetes. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al., editors. Endotext. South Dartmouth, MA: MDText.com, Inc., Dartmouth Publishing; Jun 8 2021.

Pozzo MJ, Mociulsky J, Martinez ET, Senatore G, Farias JM, Sapetti A, et al. Diabetes and quality of life: Initial approach to depression, physical activity, and sexual dysfunction. Am J Ther. 2016;23(1):e159-71. doi: 10.1097/01.mjt.0000433949.24277.19, PMID 24858335

Mazzilli F. Erectile dysfunction: Causes, diagnosis and treatment: An update. J Clin Med. 2022;11(21):6429. doi: 10.3390/jcm11216429, PMID 36362656

Abu Ali RM, Al Hajeri RM, Khader YS, Shegem NS, Ajlouni KM. Sexual dysfunction in Jordanian diabetic women. Diabetes Care. 2008;31(8):1580-1. doi: 10.2337/dc08-0081, PMID 18458140

Jacobson AM, Braffett BH, Cleary PA, Dunn RL, Larkin ME, Wessells H, et al. Relationship of urologic complications with health-related quality of life and perceived value of health in men and women with type 1 diabetes: The diabetes control and complications trial/ Epidemiology of interventions and complications (DCCT/EDIC) cohort. Diabetes Care. 2015 Oct;38(10):1904-12. doi: 10.2337/dc15- 0286, PMID 26203062

Joshi SR. Incidence data on diabetes from India. J Assoc Physicians India. 2008;56:149-51. PMID 18697629

Vijayakumar G, Manghat S, Vijayakumar R, Simon L, Scaria LM, Vijayakumar A, et al. Incidence of type 2 diabetes mellitus and prediabetes in Kerala, India: Results from a 10-year prospective cohort. BMC Public Health. 2019 Jan 31;19(1):140. doi: 10.1186/s12889-019- 6445-6, PMID 30704495

Ziaei-Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in patients with diabetes: A study from Iran. Reprod Biol Endocrinol. 2010;8:50. doi: 10.1186/1477-7827-8-50, PMID 20482781

Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):822-30. doi: 10.1016/s0090-4295(97)00238-0, PMID 9187685

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208. doi: 10.1080/009262300278597, PMID 10782451

Hatzichristou D, Kirana PS, Banner L, Althof SE, Lonnee-Hoffmann RA, Dennerstein L, et al. Diagnosing sexual dysfunction in men and women: sexual history taking and the role of symptom scales and questionnaires. J Sex Med. 2016;13(8):1166-82. doi: 10.1016/j.jsxm.2016.05.017, PMID 27436074

AlMogbel TA, Amin HS, AlSaad SM, AlMigbal TH. Prevalence of sexual dysfunction in Saudi women with Type 2 diabetes: Is it affected by age, glycemic control or obesity? Pak J Med Sci. 2017;33(3):732-7. doi: 10.12669/pjms.333.12166, PMID 28811804

Singh S, Acharya S. Waist hip ratio as predictor of incident diabetes in young adults. Indian J Clin Anat Physiol. 2020;7(1):32-5. doi: 10.18231/j.ijcap.2020.008

Cho NH, Ahn CW, Park JY, Ahn TY, Lee HW, Park TS, et al. Prevalence of erectile dysfunction in Korean men with type 2 diabetes mellitus. Diabet Med. 2006;23(2):198-203. doi: 10.1111/j.1464- 5491.2005.01789.x, PMID 16433719

Romeo JH, Seftel AD, Madhun ZT, Aron DC. Sexual function in men with diabetes type 2: Association with glycemic control. J Urol. 2000;163(3):788-91. doi: 10.1016/S0022-5347(05)67805-6, PMID 10687978

Fatemi SS, Taghavi SM. Evaluation of sexual function in women with type 2 diabetes mellitus. Diab Vasc Dis Res. 2009;6(1):38-9. doi: 10.3132/dvdr.2009.07, PMID 19156627

Doruk H, Akbay E, Cayan S, Akbay E, Bozlu M, Acar D. Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl. 2005;51(1):1-6. doi: 10.1080/014850190512798, PMID 15764412

Berger MH, Messore M, Pastuszak AW, Ramasamy R. Association between infertility and sexual dysfunction in men and women. Sex Med Rev. 2016;4(4):353-65. doi: 10.1016/j.sxmr.2016.05.002, PMID 27872029

Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151-7. doi: 10.1016/j. amjmed.2006.06.010, PMID 17275456

Yehuda R, Lehrner A, Rosenbaum TY. PTSD and sexual dysfunction in men and women. J Sex Med. 2015;12(5):1107-19. doi: 10.1111/ jsm.12856, PMID 25847589

Giraldi A, Kristensen E. Sexual dysfunction in women with diabetes mellitus. J Sex Res. 2010;47(2):199-211. doi: 10.1080/00224491003632834, PMID 20358461

Kandeel FR, Koussa VK, Swerdloff RS. Male sexual function and its disorders: Physiology, pathophysiology, clinical investigation, and treatment. Endocr Rev. 2001;22(3):342-88. doi: 10.1210/ edrv.22.3.0430, PMID 11399748

El-Sakka AI. Characteristics of erectile dysfunction in Saudi patients. Int J Impot Res. 2004;16(1):13-20. doi: 10.1038/sj.ijir.3901124, PMID 14963466

El-Sakka AI, Tayeb KA. Erectile dysfunction risk factors in noninsulin-dependent diabetic Saudi patients. J Urol. 2003;169(3):1043-7. doi: 10.1097/01.ju.0000050080.21839.f9, PMID 12576842

El-Sakka AI, Sayed HM, Tayeb KA. Androgen pattern in patients with type 2 diabetes-associated erectile dysfunction: Impact of metabolic control. Urology. 2009;74(3):552-9. doi: 10.1016/j. urology.2009.02.077, PMID 19592073

Hamdan FB, Al-Matubsi HY. Assessment of erectile dysfunction in diabetic patients. Int J Androl. 2009;32(2):176-85. doi: 10.1111/j.1365- 2605.2008.00873.x, PMID 18298568

Lu CC, Jiann BP, Sun CC, Lam HC, Chu CH, Lee JK. Association of glycemic control with risk of erectile dysfunction in men with type 2 diabetes. J Sex Med. 2009 Jun;6(6):1719-28. doi: 10.1111/j.1743- 6109.2009.01219.x, PMID 19473477

Binmoammar TA, Hassounah S, Alsaad S, Rawaf S, Majeed A. The impact of poor glycaemic control on the prevalence of erectile dysfunction in men with type 2 diabetes mellitus: A systematic review. JRSM Open. 2016;7(3):2054270415622602. doi: 10.1177/2054270415622602, PMID 26981254

Maiorino MI, Bellastella G, Giugliano D, Esposito K. From inflammation to sexual dysfunctions: A journey through diabetes, obesity, and metabolic syndrome. J Endocrinol Invest. 2018;41(11):1249-58. doi: 10.1007/s40618-018-0872-6, PMID 29549630

Gerber RE, Vita JA, Ganz P, Wager CG, Araujo AB, Rosen RC, et al. Association of peripheral microvascular dysfunction and erectile dysfunction. J Urol. 2015;193(2):612-7. doi: 10.1016/j. juro.2014.08.108, PMID 25196657

Gandaglia G, Briganti A, Jackson G, Kloner RA, Montorsi F, Montorsi P, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014;65(5):968-78. doi: 10.1016/j.eururo.2013.08.023, PMID 24011423