Frequency and Predictors of Erectile Dysfunction in Bangladeshi Men with Type 2 Diabetes Mellitus: Experience from a Tertiary Center

Abstract

Erectile dysfunction (ED) is a common complication of diabetes mellitus. But it is frequently under diagnosed and may result in poor quality of life. Previous studies have shown a high frequency of ED in diabetic men. The aim of this cross-sectional study was to determine the frequency of ED and explore its risk factors in type 2 diabetic (T2DM) men in Bangladesh. During August 2013 to July 2014, 508 diabetic men aged 30-69 years were interviewed at the outpatient and inpatient departments of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM), Dhaka, Bangladesh. Recent biochemical data (within last 6 months) were collected from the patient's diabetes guide book and hospital records. Erectile function (EF) was assessed using the validated Bengali version of the International Index of Erectile Function-15 (IIEF-15) questionnaire. Out of 508 type 2 diabetic men, ED was found in 306(60.2%) patients. The frequency of ED was increased with age from 35.5% in men aged 28-39 years to 100% in those aged 60 years and above (p<0.001). Increasing age was also associated with an increase in the severity of ED (5.5% severe ED in 28-39 years age group vs. 77.4% in 60-69 years group, p=0.000). Duration of diabetes was also associated with the increase in both frequency and severity of ED (20.2% ED and 2.4% severe ED in diabetes duration 0-5 years vs. 100% ED and 100% severe ED in diabetes duration >20 years, p=0.000). The frequency of ED in patients with good and poor glycemic control was 3.5% and 71.6% respectively (p=0.000); frequency of severe ED was also higher in uncontrolled diabetic males (0% vs. 28.4% in controlled vs. uncontrolled DM, p=0.000). The characteristics found to be significantly associated with erectile dysfunction were: patient's age, housebound bedridden status, sedentary work, diabetes duration, HbA1c level, microvascular complications, IHD, and diuretic drugs use. Moderate physical activity was found to be inversely related to the frequency of erectile dysfunction. The frequency of ED is very high among Bangladeshi T2DM male and the frequency and severity of ED may be reduced by improving glycemic status.