Abstract
The aims of this study were to investigate the prevalence of ED in Chinese men with type 2 diabetes mellitus, and evaluate the efficacy and safety of sildenafil citrate in these patients. Patients from 42 outpatient diabetes clinics with type 2 diabetes mellitus and ED as defined by the International Index of Erectile Function (IIEF)-5 were studied. Participants with ED received three doses (100 mg each) of sildenafil citrate for use over 3 months. Efficacy of sildenafil citrate was assessed using the IIEF-5 and the Global Efficacy Questionnaire (GEQ). Adverse events were recorded by patients in a daily diary. A total of 5477 participants were evaluated, and 75.2% had ED. Age, duration of diabetes and glycosylated hemoglobin (HbA1c) >6.5% were independently and significantly associated with the presence and degree of ED. Patients who received pharmacotherapy (N=389) reported significant improvements. The rate of erections as determined by the GEQ was also significantly improved following treatment. ED is a common complication in Chinese men with type 2 diabetes mellitus, and certain risk factors are associated with the presence of ED and severity. Sildenafil citrate is a safe and effective treatment for these patients.
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References
NIH Consensus Conference: Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 1994; 151: 54–61.
McCulloch DK, Campbell IW, Wu Prescott RJ, Clarke BF . The prevalence of diabetic impotence. Diabetologia 1980; 18: 279–283.
Rundles RW . Diabetic neuropathy. Medicine (Baltimore) 1945; 24: 111–159.
Rubin A, Babbott D . Impotence in diabetes mellitus. JAMA 1958; 168: 498–500.
Zemel P . Sexual dysfunction in the diabetic patient with hypertension. Am J Cardiol 1988; 61: 27H–233H.
Whitehead ED, Klyde BJ . Diabetes-related impotence in the elderly. Clin Geriat Med 1990; 6: 771–795.
Price DE, Cooksey G, Jehu D, Bentley S . The management of impotence in diabetic men by vacuum tumescence therapy. Diabetic Med 1991; 8: 964–967.
Mulligan T, Retchin SM, Chinchilli VM, Bettinger CB . The role of aging and chronic diseases in sexual dysfunction. J Am Geriatr Soc 1988; 36: 520–524.
De Berardis G, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, Kaplan SH et al. Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked. Diabetes Care 2002; 25: 284–291.
Lehman TP, Jacobs JA . Etiology of diabetic impotence. J Urol 1983; 129: 291–294.
Saenz de Tejada L, Azadzoi K, Krane RJ, Cohen RA . Impaired neurogenic and endothelium-mediated relaxation of penile smooth muscle from diabetic men with impotence. New Engl J Med 1989; 320: 1025–1030.
The Collaborative Study Group for Multi-Center Clinical Study of ED prevalence in Beijing. Prevalence of erectile dysfunction among outpatients in Beijing. Chin J Med Guide 2003; 5: 194–197.
Linet OI, Ogrinc F . Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. N Engl J Med 1996; 334: 873–877.
Wiles P . Successful noninvasive management of erectile impotence in diabetic men. Br Med J (Clin Res Ed) 1998; 96: 161–162.
Padma-Nathan H, Hellstrom WJ, Kaiser FE, Labasky RF, Lue TF, Nolten WE et al. Treatment of men with erectile dysfunction with transurethral alprostadil. Medicated Urethral System for Erection (MUSE) Study Group. N Engl J Med 1997; 336: 1–7.
Boolell M, Allen MJ, Ballard SA, Gepi-Attee S, Muirhead GJ, Naylor AM et al. Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Int J Impot Res 1996; 8: 47–52.
Moreland RB, Goldstein I, Traish A . Sildenafil, a novel inhibitor of phosphodiesterase type 5 in human corpus cavernosum smooth muscle cells. Life Sci 1998; 62: PL309–PL318.
Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA . Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med 1998; 338: 1397–1404.
Boulton AJ, Selam JL, Sweeney M, Ziegler D . Sildenafil citrate for the treatment of erectile dysfunction in men with type II diabetes mellitus. Diabetologia 2001; 44: 1296–1301.
Rendell MS, Rajfer J, Wicker PA, Smith MD . Sildenafil for treatment of erectile dysfunction in men with diabetes: a randomized controlled trial. Sildenafil Diabetes Study Group. JAMA 1999; 281: 421–426.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2004; 27: S5–S10.
Rosen RC, Riley A, Wagner G, Osterloh HI, Kirkpatrick J, Mishra A . The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.
Siu SC, Lo SK, Wong KW, Ip KM, Wong YS . Prevalence of and risk factors for erectile dysfunction in Hong Kong diabetic patients. Diabet Med 2001; 18: 732–738.
Lau JTF, Kim JH, Tsui H-Y . Prevalence of male and female sexual problems, perceptions related to sex and association with quality of life in a Chinese population: a population-based study. Int J Impot Res 2005; 17: 494–505.
Nicolosi A, Moreire Jr ED, Shirai M, Tambi MIB, Glasser DB . Epidemiology of erectile dysfunction in four counties: cross-national study of the prevalence and correlates of erectile dysfunction. Urology 2003; 61: 201–206.
Ponholzer A, Temml C, Mock K, MArszalek M, Obermayr R, Madersbacher S . Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol 2005; 47: 80–86.
Giuliano FA, Leriche A, Jaudinot EO, De Gebdre AS . Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology 2004; 64: 1196–1201.
Yamasaki H, Ogawa K, Sasaki H, Nakao T, Wakasaki H, Matsumoto E et al. Prevalence and risk factors of erectile dysfunction in Japanese men with type 2 diabetes. Diabetes Res Clin Pract 2004; 66: S173–S177.
Fedele D, Bortolotti A, Coscelli C, Santeusanio F, Chatenoud L, Colli E et al. Erectile dysfunction in type 1 and type 2 diabetics in Italy. Int J Epidemiol 2000; 29: 524–531.
Kalter-Leibovici O, Wainstein J, Harman-Bohem I, Murad H, Raz I . Clinical, socioeconomic, and lifestyle parameters associated with erectile dysfunction among diabetic men. Diabetes Care 2005; 28: 1739–1744.
Thomas GN, Tomlinson B, Abdullah ASM, Yeung VTF, Chan JCN, Wong KS . Association of erectile dysfunction with cardiovascular risk factors and increasing existing vascular disease in male Chinese type 2 diabetic patients. Diabetes Care 2005; 28: 2051–2053.
Andersson KE, Wagner G . Physiology of penile erection. Physiol Rev 1995; 75: 191–236.
Kaiser DR, Billups K, Mason C, Wetterling R, Lundberg JL, Bank AJ . Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.
Gerritsen J, Dekker JM, TenVoorde BJ, Bertelsmann FW, Kostense PJ, Stehouwer CD et al. Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study. Diabetologia 2000; 43: 561–570.
De Angelis L, Marfella MA, Siniscalchi M, Marino L, Nappo F, Giugliano F et al. Erectile and endothelial dysfunction in type II diabetes: a possible link. Diabetologia 2001; 44: 1155–1160.
Demir T, Cömlekci A, Demir O, Gülcü A, Caliskan S, Argun L et al. A possible new risk factor in diabetic patients with erectile dysfunction: homocysteinemia. J Diabetes Complications 2008; 22: 395–399.
Pierce Gl, Beske SD, Lawson BR, Southall KL, Benay FJ, Donato AJ et al. Weight loss alone improves conduit and resistance artery endothelial function in young and older overweight/obese adults. Hypertension 2008; 52: 72–79.
Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. AMA 2004; 291: 2978–2984.
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM . Development and evaluation of an abridged 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.
Veronelli A, Masu A, Ranieri R, Rognoni C, Laneri M, Pontiroli AE . Prevalence of erectile dysfunction in thyroid disorders: comparison with control subjects and with obese and diabetic patients. Int J Impot Res 2006; 18: 111–114.
Wang YX, Leng J, Vhen B, Huang XY . The prevalence of erectile dysfunction in elder adults in Shanghai (an analysis of 1582 cases). Int J Impot Res 1997; 9: S45.
Romeo JH, Seftel AD, Madhun ZT, Aron DC . Sexual function in men with diabetes type 2: association with glycemic control. J Urol 2000; 163: 788–791.
Roth A, Kalter-Leibovici O, Kerbis Y, Tenenbaum-Koren E, Chen J, Sobol T et al. Prevalence and risk factors for erectile dysfunction in men with diabetes, hypertension, or both diseases: a community survey among 1412 Israeli men. Clin Cardiol 2003; 26: 25–30.
Ei-Sakka AI . Efficacy of sildenafil citrate in treatment of erectile dysfunction: effect of type 2 diabetes. Eur Urol 2004; 46: 503–509.
Chew KK, Earle CM, Stuckey BGA, Jamrozik K, Keogh EJ . Erectile dysfunction in general medicine practice: prevalence and clinical correlates. Int J Impot Res 2000; 12: 41–45.
Bansal S . Sexual dysfunction in hypertensive men: a critical review of the literature. Hypertension 1988; 12: 1–10.
Greenstein A, Chen J, Miller H, Matzkin H, Villa Y, Braf Z . Does severity of ischemic coronary disease correlate with erectile function? Int J Impot Res 1997; 9: 123–126.
Bulpitt CJ, Dollery CT, Carne S . A symptom questionnaire for hypertensive patients. J Chronic Dis 1974; 27: 309–323.
Slag MF, Morley JE, Elson MK, Trence DL, Nelson CJ, Nelson AE et al. Impotence in medical clinic outpatients. JAMA 1983; 249: 1736–1740.
Barksdale JD, Gardner SF . The impact of first-line antihypertensive drugs on erectile dysfunction. Pharmacotherapy 1999; 19: 573–581.
Baldwin DS . Sexual dysfunction associated with antidepressant drugs. Expert Opin Drug Saf 2004; 3: 457–470.
Ricci E, Parazzini F, Mirone V, Imbimbo C, Palmieri A, Bortolotti A et al. Current drug use as risk factor for erectile dysfunction: results from an Italian epidemiological study. Int J Impot Res 2003; 15: 221–224.
Jaffe A, Chen Y, Kisch ES, Fischel B, Alon M, Stern N . Erectile dysfunction in hypertensive subjects: assessment of potential determinations. Hypertension 1996; 28: 859–862.
Klein R, Klein BE, Lee KE, Moss SE, Cruickshanks KJ . Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 1996; 19: 135–141.
Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000; 30: 328–338.
Stuckey BG, Jadzinsky MN, Murphy LJ, Montorsi F, Kadioglu A, Fraige F et al. Sildenafil citrate for treatment of erectile dysfunction in men with type 1 diabetes. Diabetes Care 2003; 26: 279–284.
Morales A, Gingell C, Collins M, Wicker PA, Osterloh IH . Clinical safety of oral sildenafil citrate (VIAGRA) in the treatment of erectile dysfunction. Int J Impot Res 1998; 10: 69–74.
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This work was supported by Independent Research Fund of Pfizer Pharmaceuticals Limited (no. PRC-IZ-02-002).
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The Collaborative Study Group for multicenter clinical study of erectile dysfunction in Chinese men with type 2 diabetes in China.
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Yang, G., Pan, C. & Lu, J. Prevalence of erectile dysfunction among Chinese men with type 2 diabetes mellitus. Int J Impot Res 22, 310–317 (2010). https://doi.org/10.1038/ijir.2010.21
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DOI: https://doi.org/10.1038/ijir.2010.21
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