Androgen deficiency, erectile dysfunction and chronic microvascular complications in male diabetic patients

Abstract

Abstract Background and aim: Erectile dysfunction (ED) can be present in diabetic patients not only induced by androgen deficiency, but also as a consequence of diabetes chronic complications. The aim of our study was to evaluate androgen status and chronic microvascular complications in patients with diabetes mellitus (DM), with and without ED. Material and methods: 292 patients (44 Type 1 diabetes - T1DM/ 248 Type 2 diabetes - T2DM), were evaluated for androgen status: dehydroepiandrosterone (DHEA), free testosterone (FT) and presence of chronic complications. ED was diagnosed by a score under 22 of 5-item International Index of Erectile Function (IIEF). Patients with free-testosterone < 70 pg/ml were considered hypogonadal. Results: Prevalence of ED was higher in T2DM 87.5% than in T1DM 65.9%. In patients with ED the prevalence of hypogonadism was 31.3% in T1DM, 26.7% in T2DM. In older T2DM patients IIEF-score was significantly correlated with DHEA. There was a significant correlation between ED and retinopathy in T1DM, additionally with neuropathy in T2DM. Conclusions: ED is a common comorbidity in diabetic patients, associated with other microvascular complications. Hypogonadal status might explain up to 30% of ED. In older diabetic men, severity of ED is related to lower DHEA.