Diabetic Men Research Articles

Prevalence and Correlates of Sexual Dysfunction in Patients With Type 2 Diabetes at an Endocrine Clinic in Hamadan, Iran

Diabetes is a metabolic disorder associated with severe medical consequences such as mental illness and sexual dysfunction in adults. In this cross-sectional study, 283 patients with type 2 diabetes, aged 20 to 70 and married, were selected in 2022-2023. Women’s sexual function was evaluated with the Female Sexual Function Index (FSFI), and men’s sexual function was evaluated with the International Index of Erectile Function (IIEF). Based on the results, 49.8% were men and 50.2% were women. The mean age of the patients was 48.13±8.90 years. The prevalence of sexual dysfunction among men and women was 100% and 66.2%, respectively. A negative correlation was observed between sexual dysfunction and age in women (P=0.043) and men (P<0.001) and a negative relationship was also found between sexual dysfunction and the duration of diabetes in men (P=0.026). Sexual dysfunction is widespread among women and men with diabetes, and due to its adverse effect on the quality of life and marital relationships, it should be taken into consideration.

Sporotrichosis Presenting as a Severe Ulcer in an Elderly Diabetic Man.

Sporotrichosis Presenting as a Severe Ulcer in an Elderly Diabetic Man.

Associations between anthropometric indices as complementary predictors and incidence of type 2 diabetes; Panasonic Cohort Study 21

AimsTo compare the predictive abilities of body mass index (BMI), waist circumference (WC), waist-corrected BMI (wBMI), a body shape index (ABSI), and waist-to-height ratio (WHtR) for the incidence of type 2 diabetes and determine the practical cut-off values for the Japanese population. MethodsThis study used data from 155,623 participants who had medical checkups with Panasonic Corporation between 2008 and 2021. Predictive abilities of anthropometric indices were evaluated at 13 years using time-dependent receiver operating characteristic (ROC) curve analyses. Results8,800 developed type 2 diabetes during the study period. The area under the ROC curve for the WHtR was high (0.717, 95 % confidence interval [CI]: 0.710–0.724), with cut-off value of 0.497 in men, while those for wBMI (0.829, 95 % CI: 0.808–0.848) and WHtR (0.826, 95 % CI: 0.806–0.845) were high in women, with cut-off values of 18.6 kg/m and 0.510, respectively. It was also showed WHtR was the most effective in men, while WHtR and wBMI outperformed WC and were comparable to BMI in women for predicting type 2 diabetes. ConclusionsWHtR demonstrated superior effectiveness in predicting type 2 diabetes in men, while both WHtR and wBMI showed higher effectiveness than WC and were almost equivalent to BMI in women.

Membrane-bound receptor for advanced glycation end products (RAGE) is a stable biomarker of low-quality sperm.

Does receptor for advanced glycation end products (RAGE) on the surface membrane of the sperm cell function as a biomarker of low-quality sperm? Membrane-bound RAGE at a cellular level directly correlates with low sperm motility, high cell permeability, decreased mitochondrial function, DNA fragmentation, and higher levels of apoptosis. RAGE has previously been measured by ELISA in low-quality sperm in diabetic men and has been shown to correlate with DNA fragmentation (terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay). Semen samples were recovered from 60 non-obese, non-diabetic and non-smoking subjects, washed with fresh media, and analysed directly or purified further by differential gradient centrifugation (DGC) or fractionated by direct swim-up before being analysed for sperm motility and molecular health parameters, including cell membrane permeability, cell death, mitochondrial membrane potential, DNA fragmentation, and RAGE protein expression. Sperm motility assessments were carried out by computer-assisted sperm analysis (CASA) on 1000 spermatozoa for washed samples and 300 spermatozoa for purified samples. Molecular sperm health parameters were evaluated using flow cytometry with the use of the following markers: DAPI for cell membrane permeability, Annexin V/DAPI for cell death (apoptosis and necrosis), MitoTracker® Red CMXRos for mitochondrial membrane potential, TUNEL assay for DNA fragmentation and 8-hydroxy-2-deoxyguanosine for identification of oxidative damage to sperm DNA, and contrasted to membrane-bound RAGE expression levels, which were evaluated using an anti-RAGE monoclonal mouse antibody. RAGE protein was shown to be present on the acrosomal and equatorial regions of sperm, with the levels of membrane bound receptor strongly correlating with poor sperm health across all parameters tested; motility (R 2 = 0.5441, P < 0.0001) and mitochondrial membrane potential (R 2 = 0.6181, P < 0.0001) being of particular note. The analysis was performed at a single cell level thereby removing confounding complications from soluble forms of the RAGE protein that can be found in seminal plasma. The expression of the RAGE protein was shown to be stable over time and its levels are therefore not subject to variation in sample handling or preparation time. N/A. Inclusion criteria for this study were non-diabetic, non-obese and non-smoking participants to assess the distribution of RAGE expression in the general population, thereby excluding disease conditions that may increase RAGE expression in sperm or contribute to low sperm quality. The study does not address how RAGE expression may be affected in other patient subpopulations or disease states associated with male infertility. Sperm analysis by flow cytometry is not amenable to the study of males with a low sperm count. Results of this study suggest that RAGE expression is a molecular maker of sperm cell health, which may be used for improvements in assisted reproduction through the removal of RAGE expressing sperm and facilitate in the diagnoses of unexplained infertility through its use as a biomarker of male infertility. The study was funded by the Irish Research Council under the Government of Ireland Programme (GOIPG/2015/3729) and the Enterprise Ireland Innovation Partnership Programme (IP-2020-0952). All authors declare no competing interests.

The Curse of Plenty: The Green Revolution and the Rise in Chronic Disease

The rising rate of chronic disease is a leading driver of the global disease burden. Yet, its determinants are not fully understood. Exploiting the Green Revolution and its expansion in historically groundwater-rich Indian districts, we examine the unanticipated contribution of agricultural productivity growth to the rise in chronic, diet-related diseases. We find that areas with greater adoption of new staple varieties saw an increase in diabetes in men born after the introduction of high-yield crops. We find suggestive evidence that diet is an important mechanism, such as heterogeneous impacts with respect to dietary habits and increases in household calorie consumption. (JEL I12, O13, O15, O31, Q12, Q16)

Sex-specific association between carbohydrate antigen 19–9 and incident type 2 diabetes

Carbohydrate antigen 19–9 (CA19-9) levels are associated with glycemic control, insulin resistance, and chronic complications in patients with type 2 diabetes (T2D). Women generally show higher CA19-9 levels despite a greater T2D prevalence in men. We evaluated the sex-specific longitudinal associations between CA19-9 levels and T2D incidence. Korean adults (n = 329,380) without previous cancer or T2D were categorized into four groups based on their CA19-9 levels. The study end point was the development of incident T2D during follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) according to CA19-9 levels. During a median follow-up of 6.1 years (3.3–9.3 years), the incidence rates of T2D were 9.9 per 1,000 person-years in men and 3.6 per 1,000 person-years in women. In the time-dependent analysis, adjusted HRs (95% confidence intervals) for incident T2D comparing CA19-9 levels of 10.0–19.9, 20.0–29.9, and ≥ 30 U/mL to the reference (< 10 U/mL) were 1.08 (1.04–1.13), 1.18 (1.07–1.30), and 1.64 (1.35–1.99), respectively, among men. However, this association was not observed in women. The association between CA19-9 category and incident T2D significantly differed by sex (Pinteraction = 0.006). Among young and middle-aged Korean adults, elevated CA19-9 levels were significantly associated with increased risk of type 2 diabetes in men but not in women. Elevated CA19-9 levels in men could be a useful marker for identifying individuals at high risk of developing T2D. Evaluation approaches for individuals with elevated CA19-9 levels should be sex-specific.

Beyond T-Trials, T4DM and TRAVERSE: the next large testosterone randomized controlled trial.

Lower testosterone concentrations have been associated with poorer health outcomes in ageing men, but proving causality and demonstrating potential for therapeutic benefit requires randomized clinical trials (RCTs). This review discusses recent observational findings and results of major testosterone RCTs, to explore the need for another, larger trial. Evidence of Leydig cell impairment emerges in men above the age of 70 years. Lower testosterone is associated with diabetes risk, and also risk of incident dementia. An individual participant data meta-analysis found that below thresholds of testosterone of 7.4 nmol/L and 5.3 nmol/l respectively, risks of all-cause mortality and cardiovascular deaths in men increased. Testosterone for the Prevention of Type 2 Diabetes Mellitus (T4DM), a multicentre RCT, showed that testosterone treatment prevented or reverted type 2 diabetes in men at high risk. Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE), a cardiovascular safety trial, demonstrated cardiovascular and prostate safety of testosterone treatment in men with or at risk of cardiovascular disease. T4DM confirmed findings from the Testosterone Trials (T-Trials) that testosterone improved sexual function, and bone microarchitecture and density. However, in TRAVERSE, testosterone-treated men had a higher risk of clinical bone fractures, but not major osteoporotic fractures. Men with disorders of the hypothalamic-pituitary-testicular (HPT) axis causing androgen deficiency warrant consideration for testosterone therapy. In men with an intact HPT axis, testosterone treatment is a pharmacological intervention which requires justification from high quality RCT data. Currently, there is insufficient evidence to justify wider use of testosterone for prevention of cardiometabolic disease. However, there is scope for another large testosterone RCT to investigate whether testosterone treatment might, in older men, extend disability-free survival.

Tadalafil use is associated with a lower incidence of Type 2 diabetes in men with benign prostatic hyperplasia: A population-based cohort study.

Tadalafil, commonly prescribed for benign prostatic hyperplasia (BPH), may benefit patients with Type 2 diabetes mellitus (T2DM) for glycemic markers and complications. However, the association between the long-term use of tadalafil and the incidence of T2DM has not been investigated. We emulated a target trial of tadalafil use (5mg/day) and the risk of T2DM using a population-based claims database in Japan. Patients who initiated tadalafil or alpha-blockers for BPH and had no history of diabetes diagnosis, no dispensing of glucose-lowering drugs, and no history of hemoglobin A1c levels of ≥6.5% (47-48mmol/mol) were included. The primary outcome was the incidence of T2DM. Pooled logistic regression was used to estimate adjusted risk ratios (RRs) and 5-year cumulative incidence differences (CIDs). A total of 5180 participants initiated tadalafil treatment and were compared with 20,049 patients who initiated alpha-blockers. The median follow-up time for each arm was 27.2 months (interquartile range [IQR], 12.0-47.9) in tadalafil users and 31.3 months (IQR, 13.7-57.2) in alpha-blocker users. The incidence rates of T2DM in tadalafil and alpha-blocker users were 5.4 (95% confidence interval [CI], 4.0-7.2) and 8.8 (95% CI, 7.8-9.8) per 1000-person years, respectively. Initiation of tadalafil was associated with a reduced risk of T2DM (RR, 0.47; 95% CI, 0.39-0.62; 5-year CID, -0.031; 95% CI, -0.040 to -0.019). The incidence of T2DM was lower in men with BPH treated with tadalafil than in those treated with alpha-blockers. Thus, tadalafil may be more beneficial than alpha-blockers in preventing T2DM.

The Global Prevalence of Sedentary Time in Diabetes and Metabolic Syndrome: A Systematic Review and Meta-Analysis.

We aimed to determine the prevalence of sedentary time in diabetes and metabolic syndrome worldwide via a systematic review and meta-analysis study. This study was conducted using the systematic review method following PRISMA 2020 criteria. Searches were conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from January 2000 to December 2022. The heterogeneity of studies was measured using the I2 test. The prevalence of sedentary time in diabetic patients was 52.3% (CI 95 %:46.2-58.2) and the prevalence of sedentary time in metabolic syndrome was 43.3% (95% CI: 31- 56.5). Also, the results of subgroup analysis show that the prevalence of inactivity in diabetic women was 60.3% higher than that of diabetic men. The prevalence of inactivity in patients with metabolic syndrome was 28.6% in men and women, respectively. Sedentary time has a very high prevalence in metabolic syndrome and diabetic patients. In other words, almost half of these patients experience their life patterns. Therefore, effective and efficient efforts to improve activity and exercise in patients with diabetes and metabolic syndrome will have a more effective therapeutic effect and improve their quality of life.

Changes in the Prevalence of Diabetes in Bulgaria over an 18-Year Period (2006-2024)

The international medical community is increasingly aware that diabetes is a major global health threat and poses increasing challenges to public health and health systems worldwide. &amp;lt;i&amp;gt;Aim:&amp;lt;/i&amp;gt; To compare the results of three national cross-sectional studies on diabetes prevalence in Bulgaria (2006, 2012 and 2024) and to assess the dynamics. &amp;lt;i&amp;gt;Material and Methods:&amp;lt;/i&amp;gt; The three studies included 2396, 2033 and 936 subjects respectively. The United Nation / The International Diabetes Federation (2006) diagnostic criteria were applied, and the data were evaluated according to type of settlement and age. &amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;Diabetes prevalence was 7.9% in 2006 and 9.55% in 2012 (p = 0.06). This difference is due to the greater rise in men (9.2% to 11.5%, p = 0.09) compared to women (6.9% to 7.7%, NS). In the next period, 2012 - 2024, the prevalence of diabetes in general, as well as the prevalence in men and women increased significantly. (Diabetes in general - from 9.6% to 15.7%, p &amp;lt; 0.001; diabetic men - from 11.5% to 21.2%, p &amp;lt; 0.001; diabetic women – from 7.8% to 10.4%, p &amp;lt; 0.016). The prevalence of diabetes nearly doubled, while the population decreased and its structure, lifestyle and diet changed. Obesity significantly increased over a 18-year period - 2024 vs. 2006 (33.3% vs. 26.7%, p &amp;lt; 0.001). The prevalence of diabetes increased with age, with significant rise in the 30-39 age group for 2012 - 2024, from 1.7% to 4.5% (p &amp;lt; 0.047) and more sharply when comparing 2006 - 2024 – from 0.9% to 4.5% (p &amp;lt; 0.002). There was a similar increase in the next age group. For the age 60-79, the prevalence reached 29.9%, i.e. every third person. As arterial hypertension is significantly more common in diabetics, its role as a risk factor is indisputable. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; The health care system should be readjusted according to the new reality for early diagnose of diabetes in risk groups and adequate modern care.

A Randomized Controlled Trial to Determine the Impact of Resistance Training versus Aerobic Training on the Management of FGF-21 and Related Physiological Variables in Obese Men with Type 2 Diabetes Mellitus.

Fibroblast growth factor 21 (FGF-21) has been suggested as a potential therapeutic target for insulin resistance in health-related metabolic disorders such as type 2 diabetes. Despite the metabolic effects of resistance (RT) and aerobic training (AT) on diabetes symptoms, uncertainty exists regarding the superiority of effects manifested through these training approaches on FGF-21 and biochemical and physiological variables associated with metabolic disorders in men diagnosed with type 2 diabetes. This study aimed to investigate the impact of a 12-week RT and AT on FGF-21 levels and symptoms associated with metabolic disorders in male individuals diagnosed with type 2 diabetes. Thirty-six sedentary obese diabetic men (40 to 45 years old) were matched based on the level of FGF-1. They and were randomly divided into two training groups (RT, n = 12 and AT, n = 12) performing three days per week of moderate-intensity RT or AT for 12 weeks and an inactive control group (n = 12). Both training interventions significantly improved FGF-21, glucose metabolism, lipid profile, hormonal changes, strength, and aerobic capacity. Subgroup analysis revealed that RT had greater adaptive responses (p < 0.01) in fasting blood sugar (ES = -0.52), HOMA-IR (ES = -0.87), testosterone (ES = 0.52), cortisol (ES = -0.82), FGF-21 (ES = 0.61), and maximal strength (ES = 1.19) compared to AT. Conversely, AT showed greater changes (p < 0.01) in cholesterol (ES = -0.28), triglyceride (ES = -0.64), HDL (ES = 0.46), LDL (ES = -0.73), and aerobic capacity (ES = 1.18) compared to RT. Overall, both RT and AT interventions yielded significant moderate to large ES in FGF-21 levels and enhanced the management of biochemical variables. RT is an effective method for controlling FGF-21 levels and glucose balance, as well as for inducing hormonal changes. On the other hand, AT is more suitable for improving lipid profiles in overweight men with type 2 diabetes mellitus.

Non-exercise estimated cardiorespiratory fitness and incident type 2 diabetes in adults

Aim(s)To examine the association between non-exercise estimated cardiorespiratory fitness (eCRF) and incident type 2 diabetes. MethodsIn a sample of 13,616 men and women without diabetes at baseline, incident type 2 diabetes were determined as fasting plasma glucose level ≥ 7 mmol/l (126 mg/dL), self-report, or insulin usage at follow-up. eCRF was calculated in metabolic equivalents (METs) at baseline using sex-specific algorithms, including physical activity, smoking status, age, body mass index, waist circumference, and resting heart rate. Cox regression models were performed, and hazard ratios (HRs), 95 % confidence intervals (CIs), and p values were reported. ResultsEach 1-MET unit increase in eCRF was associated with an 11 % lower risk of incident type 2 diabetes (p < 0.0001). Men in the upper and middle eCRF tertiles were at 46 % (95 % CI, 0.42–0.68) and 29 % (95 % CI, 0.57–0.88) lower risk of incident type 2 diabetes compared to the lower eCRF tertile (p < 0.0001). For women, there were no significant findings between eCRF tertiles and incident type 2 diabetes (p ≥ 0.11 for all). ConclusionsHigher eCRF was associated with a lower incidence of type 2 diabetes in men. Further research needs to examine the association between eCRF and type 2 diabetes in women.

Testosterone in prevention and treatment of type 2 diabetes in men: Focus on recent randomized controlled trials.

In epidemiological studies, lowered serum testosterone concentrations are common in men with obesity, prediabetes, and established type 2 diabetes (T2D). In men with prediabetes, lowered serum testosterone also predicts a future risk of T2D in men. Administration of testosterone consistently reduces fat mass and increases skeletal muscle mass-body compositional changes expected to be metabolically favorable. In men with established T2D, the effects of testosterone treatment on glycemic measures are inconsistent. Irrespective of baseline serum testosterone concentration in men with prediabetes or newly diagnosed early-onset T2D, testosterone treatment prescribed in conjunction with a lifestyle program has been reported to reduce the risk of T2D by 40% after 2 years, suggesting that either a lifestyle program is required to facilitate the glycemic benefit of testosterone treatment and/or that testosterone treatment has more favorable effects on glycemia in men early in the evolution or onset of the disease. The durability of the benefit and longer-term safety of testosterone treatment have not been established. Therefore, more studies are required before testosterone treatment can be recommended for the prevention and/or treatment of men with or at elevated risk of T2D who do not have hypogonadism due to an established disease of the hypothalamic-pituitary-testicular axis.

Sustained metabolic dysregulation and the emergence of diabetes: associations between HbA1c and metabolic syndrome components in Tunisian diabetic and nondiabetic groups

IntroductionMetabolic Syndrome (MetS), diabetes, and other noncommunicable diseases (NCDs) have been a major focus of research in recent decades as the prevalence of these conditions continues to rapidly increase globally. However, the timing and patterns of development from metabolic risk factors to disease states are less well understood and are especially critical to understand in low- and middle-income countries (LMICs) and populations undergoing epidemiological transitions.MethodsNationally representative sociodemographic, anthropometric, and point-of-care biomarker data from the 2016 Tunisian Health Examination Survey (n = 8170) were used to determine the prevalence of diabetes and MetS components in Tunisia and to investigate associations between glycated hemoglobin (HbA1c) and MetS components (blood pressure [BP], HDL cholesterol [HDL], triglycerides [TG], and waist circumference [WC]) in participants aged 15-97 years old. To better understand how sustained metabolic dysregulation and disease states impact these associations, diabetic and nondiabetic groups were analyzed separately.ResultsThe overall prevalence of diabetes based on measured HbA1c was 18.2%. The diabetic groups had a higher prevalence of each individual MetS component, and significantly higher (BP, TG, WC, and HbA1c) and lower (HDL) values than the nondiabetic groups. Yet, there were a higher number of significant associations between HbA1c and MetS components found in nondiabetic women and men when compared to diabetic women and men. HbA1c was positively associated with the cumulative number of MetS components, irrespective of diabetes status in men and women.ConclusionsThe prevalence of both diabetes and MetS components (particularly low HDL cholesterol and elevated TG) is high among the Tunisian population. More MetS components were associated with HbA1c in nondiabetic individuals, showing a strong connection between the development of MetS components and diabetes. However, once the diabetes disease state manifests, there is more variability in the relationships. These results show the potential for HbA1c to be an indicator of metabolic health below clinical disease cutoffs, which may allow insights into the physiological changes that precipitate the emergence of diabetes.

Stem cell therapy in diabetic men with erectile dysfunction: a 24-month follow-up of safety and efficacy of two intracavernous autologous bone marrow derived mesenchymal stem cells injections, an open label phase 2 clinical trial

BackgroundRecently we reported results of phase 1 pilot clinical trial of 2 consecutive intracavernous (IC) injection of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) for the first time in the treatment of diabetic patients with erectile dysfunction (DM-ED). In phase 2 of this study our aim is to evaluate long term safety and efficacy of IC injections of BM-MSC on additional eight patients with DM-ED.ResultsEach patient received 2 consecutive IC injections of BM-MSC and evaluated at 1, 3, 6, 12, and 24-month time points. Primary outcome was the tolerability and safety of stem cells therapy (SCT), while the secondary outcome was improvement of erectile function (EF) as assessed using the International Index of Erectile Function-5 (IIEF-5), Erection Hardness Score (EHS) questionnaires, and Color Duplex Doppler Ultrasound (CDDU). IC injections of BM-MSCs was safe and well-tolerated. Minor local and short-term adverse events related to the bone marrow aspiration and IC injections were observed and treated conservatively. There were significant improvement in mean IIEF-5, EHS, all over the follow-up time points in comparison to the baseline. At 24-month follow up there were significant decline in the mean IIEF-5, and EHS compared to the baseline. The mean basal and 20-min peak systolic velocity was significantly higher at 3-month after the IC injections compared to baseline.ConclusionsThis phase 2 clinical trial confirmed that IC injections of BM-MSC are safe and improve EF. The decline in EF over time suggests a need for assessing repeated injections.Clinical trial registrationNCT02945462

The Efficacy of Mediterranean Diet for Erectile Dysfunction in Diabetes Mellitus Patients: A Narrative Review

Background : Male infertility affects millions globally, with 12-15% of Indonesian couples facing conception challenges, 50% of which are attributed to male factors. Despite extensive research, 70% of male infertility cases remain idiopathic. Diabetes, a prominent factor in male infertility, affects 9.3% of the global population, with projections estimating 700 million cases by 2045. Recent studies suggest the Mediterranean diet positively impacts semen parameters, particularly in diabetic individuals. This review aims to explore the Mediterranean diet's effects on fertility in male diabetic patients. Reviews : The literature review employed three databases, focusing on in-vitro, in-vivo, pre-clinical, and clinical studies from 2014-2024. Diabetes, a chronic disease characterized by abnormal blood sugar levels, affects insulin production or effectiveness, leading to complications if left uncontrolled. Erectile dysfunction (ED), prevalent in diabetic men, is attributed to nerve and blood vessel damage from high blood sugar levels. Treatments for ED include PDE5 inhibitors, but alternative plant-based therapies are being explored. Platelet-rich plasma (PRP) has shown promise in animal studies but lacks human trial data. The Mediterranean diet, rich in plant-based foods and healthy fats, may help prevent sexual function deterioration in diabetic individuals. Comprehensive nutrition education and government efforts are crucial in promoting healthy lifestyles and ensuring access to fresh foods. Summary : In conclusion, the Mediterranean diet shows promise as a dietary intervention for improving male fertility in diabetic populations. Further research is warranted to confirm these findings and to explore the mechanisms underlying the effects of the Mediterranean diet on male fertility.

Demographic shifts and health dynamics: Exploring the impact of aging rates on health outcomes in Brazilian capitals

ObjectivesWe aimed to examine the association between population aging and the prevalence of non-communicable diseases and risk factors in the Brazilian population. Study designAn ecological study using secondary data from 2010 to 2023 of the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL). MethodsWe estimated the aging rate in 2010 and 2022 as the ratio of people aged 65 or older to those younger than 15 using the 2010 and 2022 Brazilian censuses. We calculated the absolute differences in the prevalence of non-communicable diseases (hypertension, diabetes) and their risk factors (smoking, excessive alcohol consumption, physical inactivity, obesity) and negative health perceptions in 2010 and 2023 for the 26 Brazilian states and the Federal District. Linear regression assessed the relationship between aging rate and health outcomes. We stratified the analyses to explore the differences by sex. ResultsBrazil's aging rate was higher among women than men (average of 0.20 and 0.31, respectively). The increased number of older adults was associated with a higher prevalence of excess weight and diabetes in men. In women, the aging rate was associated with a higher prevalence of smoking, excessive alcohol consumption, obesity, hypertension, and diabetes. ConclusionsOur findings show a sex-specific association between population aging and the prevalence of health conditions in the Brazilian population. By discerning the sex-specific nuances and untangling the multifactorial influences, this research aspires to contribute valuable insights to the burgeoning field of public health in the face of evolving demographic landscapes.

Effects of high-intensity statin therapy on steroid hormones and vitamin D in type 2 diabetic men: A prospective self-controlled study.

The study aimed to assess the effect of high-intensity statin therapy on testicular and adrenal steroids and vitamin D levels in type 2 diabetic men. A prospective study, conducted between March 2021 and July 2022, including 60 men with type 2 diabetes, aged 40-65 years, statin-free, and in whom treatment with high-intensity statin was indicated. The patients had two visits, before and 6 months after a daily intake of 40 mg of atorvastatin. During each visit, they underwent a clinical examination, and a fasting blood sample was collected for biological and hormonal measurements. There was a significant increase in the prevalence of decreased libido (from 22% to 47%, p = 0.001) and a significant decrease in the frequency of sexual intercourse (from 4 [1-8] to 3 [0-4] per month, p = 0.005). The median ADAM's score significantly increased (from 4 [2-7] to 6 [3-8], p = 0.000). Twenty-two percent of the patients developed gynecomastia. The median total, bioavailable and free testosterone significantly decreased from 15.1 (11.4-17.4), 6.3 (5.0-7.8), and 0.27 (0.22-0.33) nmol/L to 12.7 (10.7-15.9), 5.7 (4.4-7.0), and 0.24 (0.19-0.30) nmol/L, respectively, with no change in FSH and LH levels. Three patients (5%) developed hypogonadism (testosterone <8 nmol/L). There was a significant decrease in DHEAS from 4.5 (2.8-6.1) to 3.8 μmol/L (2.6-5.6) and no change in cortisol and vitamin D levels. High-intensity statin therapy decreased androgen levels in type 2 diabetic men with significant clinical impact.

CONTINUOUS LEFT STELLATE GANGLION BLOCK DURING VT ABLATION TO SLOW VT AND IMPROVE ABLATION OUTCOME

Abstract Introduction Perioperative management of advanced patients with indication to ventricular tachycardia (VT) ablation is complex. A PAINESD score ≥ 15 was proposed to identify those who might benefit from pre–emptive mechanical cardiopulmonary support (MCS). We present a case successfully managed with continuous percutaneous left stellate ganglion block (C–PLSGB). Case A 71–year–old diabetic man with severe post–ischemic cardiomyopathy (LVEF 24%, NYHA Class III) and chronic pulmonary disease was admitted for electrical storm with multiple ICD shocks due to poorly tolerated monomorphic VT (MMVT) at 176 bpm resistant to anti–tachycardia pacing (ATP), despite ongoing chronic oral therapy with amiodarone and carvedilol. Poorly tolerated and ATP–resistant MMVTs at 170–180 bpm recurred despite intravenous (iv) amiodarone and lidocaine (20 mcg/kg/min) and oral propranolol. Ultrasound guided C–PLSGB was therefore started; lidocaine was chosen for the continuous infusion due to the short half–life, at the initial dose of 10 mg/h; 6 hours later, his poorly tolerated MMVT recurred at 167 bpm. Therefore, at first we increased iv lidocaine to 30 mcg/kg/min, without benefit, then we increased C–PLSGB at 37.5 mg/h and decreased iv lidocaine to 20 mcg/kg/min due to neurological symptoms. With this regimen, the patient stayed VT free for 2 hours, then the clinical VT recurred at 130 bpm, with good hemodynamic tolerability and ATP–response. C–PLSGB infusion was than increased to 75 mg/h, with no more VT. Endocardial VT ablation was planned. Despite a very high PAINESD score (31) we decided to avoid pre–emptive MCS. We stopped lidocaine (both iv and as C–PLSGB) 2 hours before ablation. As soon as the patient came in the EP room (before instrumentation), the clinical MMVT recurred at 133 bpm. C–PLSGB was then resumed (initially at 100 mg/h for 30 minutes, then at 37.5 mg/h). The MMVT then spontaneously recurred at 133 bpm: it was mapped and ablated in the medio–apical anterior wall, with acute VT interruption. A second VT morphology then appeared, that was mapped and ablated at a more basal site, despite a partial epicardial component of the circuit was identified. C–PLSGB was then stopped and no more VT occurred nor were induced 1 hour later. At 8 months the patient is still alive with no more VT. Conclusion C–PLSGB with individually tailored infusion rates could be used during VT ablation as a mean to reduce VT cycle length and allow for mapping without MCS.

(192) RISK FACTORS FOR ERECTILE DYSFUNCTION IN DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Introduction Previous studies have established that diabetes mellitus (DM) markedly raises the risk of developing erectile dysfunction (ED). Despite extensive investigations, the risk factors associated with ED in diabetic men have yet to be unequivocally determined, owing to incongruent and inconclusive results reported in various studies. Objective The objective of this systematic review and meta-analysis was to assess the risk factors for ED in men with DM. Methods A comprehensive systematic review was conducted, encompassing studies published in the PubMed, Scopus and Embase databases up to August 24th, 2023. All studies examining the risk factors of ED in patients with DM were included in the analysis. To identify significant variations among the risk factors, odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were employed. The risk of bias was evaluated using the Newcastle-Ottawa Scale for longitudinal studies and the Agency for Healthcare Research and Quality Scale for cross-sectional studies. Results A total of 58 studies, encompassing a substantial participant pool of 66 925 individuals diagnosed with DM, both with or without ED, were included in the meta-analysis. Mean age (OR: 1.31, 95% CI = 1.24-1.37), smoking status (OR: 1.32, 95% CI = 1.18-1.47), HbA1C (OR: 1.44, 95% CI = 1.28-1.62), Duration of DM (OR: 1.39, 95% CI = 1.29-1.50), diabetic neuropathy (OR: 3.47, 95% CI = 2.16-5.56), diabetic retinopathy (OR: 3.01, 95% CI = 2.02-4.48), diabetic foot (OR: 3.96, 95% CI = 2.87-5.47), cardiovascular disease (OR: 1.92, 95% CI = 1.71-2.16), hypertension (OR: 1.74, 95% CI = 1.52-2.00), microvascular disease (OR: 2.14, 95% CI = 1.61-2.85), vascular disease (OR: 2.75, 95% CI = 2.35-3.21), nephropathy (OR: 2.67, 95% CI = 2.06-3.46), depression (OR: 1.82, 95% CI = 1.04-3.20), metabolic syndrome (OR: 2.22, 95% CI = 1.98-2.49), and diuretic treatment (OR: 2.42, 95% CI = 1.38-4.22) were associated with an increased risk of ED in men with DM. Conclusions Our study indicates that in men with DM, several risk factors for ED have been identified, including mean age, HbA1C, duration of DM, diabetic neuropathy, diabetic retinopathy, diabetic foot, cardiovascular disease, hypertension, microvascular disease, vascular disease, nephropathy, depression, metabolic syndrome, and diuretic treatment. By clarifying the connection between these risk factors and ED, clinicians and scientific experts can intervene and address these risk factors, ultimately reducing the occurrence of ED and improving patient management. Keywords: Diabetes Mellitus, Erectile Dysfunction, Risk factors, Meta-analysis. Disclosure No.