medwireNews: Men and women with prediabetes or type 2 diabetes have high levels of sexual dysfunction, shows an analysis of data from the Diabetes Prevention Program Outcomes Study (DPPOS) in the USA.
Metabolic factors appear to influence risk for sexual dysfunction in men in this group, whereas in women significant risk factors appear to be nonmetabolic.
The Diabetes Prevention Program (DPP) was a well-known study developed by the University of Pittsburgh that ran between 1996 and 2001 comparing treatment with metformin, intensive lifestyle intervention, or placebo in 3234 adults with prediabetes. Following the success of lifestyle intervention, the study was stopped and all participants were offered lifestyle intervention. The DPPOS followed up participants in the DPP from 2002 until the present to study long-term outcomes.
The DPPOS research was presented by Yooni Blair (University of Michigan, Ann Arbor, USA) as two abstracts at the 82nd ADA Scientific Sessions in New Orleans, Louisiana.
Commenting on the rationale for the study, Blair told delegates: “Prior studies have found an association between erectile dysfunction (ED) and type 2 diabetes; it occurs more commonly, and often earlier […]. However, data on men with prediabetes and also the risk profile for those with type 2 diabetes are lacking.”
She added: “The worldwide prevalence of diabetes is staggering, but also sexual dysfunction in men is projected to be in the hundreds of millions worldwide. This emphasizes the importance of understanding the relation between these two entities.”
For the purposes of this study, measures were taken from the DPPOS cohort at year 15 in 2017. At this point, 568 of 648 male participants completed the International Index of Erectile Function (IIEF), while 426 of 1464 female participants, all of whom were sexually active, completed the Female Sexual Function Index (FSFI).
The researchers found that 218 men in the cohort had ED – 41% of men with prediabetes and 37% of those who had developed type 2 diabetes. Men with ED tended to be older, of White ethnicity, and weigh more, and were more likely than those without ED to have depression, hypertension, and high cholesterol.
Blair highlighted that in multivariable analyses men with type 2 diabetes and the metabolic syndrome were 72% more likely to develop ED than those with diabetes alone, while exposure to lifestyle intervention appeared to significantly reduce risks for ED in men with prediabetes by 74%.
Female sexual dysfunction (FSD) – scored across six domains, including desire, arousal, lubrication, orgasm, satisfaction, and pain – was common in women with prediabetes or type 2 diabetes (43.4% overall). These women were more likely to be older, married, depressed, heavier, postmenopausal, post hysterectomy, and have urinary incontinence than those without FSD.
But, contrary to what was found in men, the research showed FSD was more closely associated with nonmetabolic factors. Depression, urinary incontinence, and Asian ethnicity were all significantly associated with FSD in this group of women with odds ratios of 2.81, 2.14 and 5.06 respectively.
“This suggests that the sexual response in women may be more affected by psychosocial aspects rather than metabolic control or complications of diabetes,” commented Blair.
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