madman
Super Moderator
Abstract
Diabetes mellitus (DM), a chronic metabolic disease characterized by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy, and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity, and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aimed to review the definition and prevalence of DM and ED, the impact of DM complications and DM treatment on ED and current and emerging treatments and novel approaches for the treatment of ED in patients with DM.
Introduction
Diabetes mellitus (DM) is one of the most common chronic diseases and is characterized by impaired carbohydrate metabolism. The incidence and prevalence of DM have increased over the years, with its complications representing a serious health problem. The long-term complications of DM include macroangiopathy, microangiopathy, and neuropathy. DM is also an important cause of sexual dysfunction (SD) in both men and women, erectile dysfunction (ED) is considered the most important SD in men with DM. A sedentary lifestyle, overweight/obesity, and increased caloric consumption have been identified as common risk factors for the development of DM and DM complications. Although lifestyle changes may help improve sexual function, specific treatments are often needed.
*This review, therefore, focuses on determining (i) the definition and prevalence of DM and ED, (ii) the impact of DM complications and other cofactors on ED and (iii) current and emerging treatments and novel approaches for the treatment of ED in patients with DM.
*Epidemiology
*The ‘complicated role’ of complications and cofactors in the pathophysiology of ED in DM
*Complications
-Cardiovascular events
-Nephropathy
-Neuropathy
*Comorbidities
-Hypertension
-Dyslipidaemia
-Obesity and MetS
-Hypogonadism
*Urologic comorbidities
*Obstructive sleep apnoea syndrome
*Depression
*Other factors
*Effects of anti-diabetic drugs on male sexuality
-Metformin
-Pioglitazone
-Glibenclamide
-SGLT-2 inhibitors
-DPP4i and GLP1RA
-Insulin
*Treatment of ED in diabetes
-Lifestyle modifications and glycaemic control
-PDE5is
-Sildenafil
-Vardenafil
-Tadalafil
-Avanafil
-Udenafil
-Microdenafil
*PDE5is and TRT
*PDE5is and the cardiovascular system
*Other treatments for ED
Conclusions
This review underscores and confirms the importance of appropriately managing patients with DM experiencing ED, highlighting the role of comorbidities, complications, and the role of anti-diabetic drugs. In this regard, both metformin and new anti-diabetic medications seem to play a protective role in ED pathogenesis. Finally, evidence shows that PDE5is could be considered safe and beneficial for CVD associated with T2DM.
Diabetes mellitus (DM), a chronic metabolic disease characterized by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy, and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity, and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aimed to review the definition and prevalence of DM and ED, the impact of DM complications and DM treatment on ED and current and emerging treatments and novel approaches for the treatment of ED in patients with DM.
Introduction
Diabetes mellitus (DM) is one of the most common chronic diseases and is characterized by impaired carbohydrate metabolism. The incidence and prevalence of DM have increased over the years, with its complications representing a serious health problem. The long-term complications of DM include macroangiopathy, microangiopathy, and neuropathy. DM is also an important cause of sexual dysfunction (SD) in both men and women, erectile dysfunction (ED) is considered the most important SD in men with DM. A sedentary lifestyle, overweight/obesity, and increased caloric consumption have been identified as common risk factors for the development of DM and DM complications. Although lifestyle changes may help improve sexual function, specific treatments are often needed.
*This review, therefore, focuses on determining (i) the definition and prevalence of DM and ED, (ii) the impact of DM complications and other cofactors on ED and (iii) current and emerging treatments and novel approaches for the treatment of ED in patients with DM.
*Epidemiology
*The ‘complicated role’ of complications and cofactors in the pathophysiology of ED in DM
*Complications
-Cardiovascular events
-Nephropathy
-Neuropathy
*Comorbidities
-Hypertension
-Dyslipidaemia
-Obesity and MetS
-Hypogonadism
*Urologic comorbidities
*Obstructive sleep apnoea syndrome
*Depression
*Other factors
*Effects of anti-diabetic drugs on male sexuality
-Metformin
-Pioglitazone
-Glibenclamide
-SGLT-2 inhibitors
-DPP4i and GLP1RA
-Insulin
*Treatment of ED in diabetes
-Lifestyle modifications and glycaemic control
-PDE5is
-Sildenafil
-Vardenafil
-Tadalafil
-Avanafil
-Udenafil
-Microdenafil
*PDE5is and TRT
*PDE5is and the cardiovascular system
*Other treatments for ED
Conclusions
This review underscores and confirms the importance of appropriately managing patients with DM experiencing ED, highlighting the role of comorbidities, complications, and the role of anti-diabetic drugs. In this regard, both metformin and new anti-diabetic medications seem to play a protective role in ED pathogenesis. Finally, evidence shows that PDE5is could be considered safe and beneficial for CVD associated with T2DM.
