Endocrine Abstracts

Background: Erectile dysfunction impairs the quality of life of men with type 1 diabetes. Many factors are involved in this complication. According to the literature, diabetic microangiopathy is associated with erectile dysfunction. The aim of our study was to evaluate the impact of diabetic retinopathy on erectile dysfunction in a group of long-standing type 1 diabetics.

Methods: We conducted a cross-sectional study that included male patients with type 1 diabetes for 20 years or more and followed at the National Institute of Nutrition of Tunis. Diagnosis and severity of erectile dysfunction were assessed by the short version of the International Index of Erectile Function (IIEF-5), translated and validated in Arabic. Diabetic retinopathy (DR) and its degree of severity were diagnosed by fundus examination and retinal angiography if abnormalties.

Results: A total of 51 men with a mean age of 41±9.7 years wereincluded in the study. Diabetes was diagnosed at the age of 14.8±7 years. Mean duration of diabetes was 26.4±6 years. Only one-fifth (21.1%) of the population did not have DR on fundus examination. Two patients had permanent blindness. DR was minimal, moderate and severe in 18.4%, 21.1% and 15.8% of participants, respectively. It was proliferative in 10.5% of patients and complicatedin 7.9%. Mean IIEF-5 score was 15.3±5.3. Erectile dysfunction was diagnosed in 85% of participants. It was mild in 39.1%, moderate in 43.5% and severe in 17.4% of cases. Univariate analysis showed a significant association between DR and erectile dysfunction (P=0.014). Severity of DR was associated with severity of erectile dysfunction (P=0.034).

Conclsion: Erectile dysfunction remains under-diagnosed and untreated in many diabetic patients. However, as our study showed, systematic screening in all patients with DR, especially in the advanced stages, should be recommended.