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      Erectile Dysfunction and Depression Prevalence Among Male Patients with Type II Diabetes

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          Abstract

          Background and Objective

          Patients with Type 2 Diabetes (T2D) are at substantial risk for developing erectile dysfunction (ED). The primary goal of this study was to assess the prevalence of ED and depression among T2D patients and the associated risk factors.

          Methods

          A cross-sectional study was conducted for adult T2D patients who had a routine clinic visit between January–August 2023. Structured questionnaires formed with two validated questionnaires – the International Index of Erectile Function short form (IIEF-5) and Patient Health Questionnaire (PHQ-9) – were used to screen for ED and depression, respectively.

          Results

          A total of 478 male patients with T2D with a mean age of 59.2 ± 10.8 years, mostly married, with long standing T2D were included. Hyperlipidemia followed by hypertension were the most reported comorbidities. Of the patients, 61.3% had reported no depression and were less likely to have ED or severe ED ( p <0.001) and more likely to be physically active and to report no smoking ( p <0.0001) when compared to those with depression. Fifty-two percent of the patients reported moderate and severe ED and those were older in age ( p = 0.031), had longer duration of T2D diagnosis ( p = 0.005), were more likely to have any comorbidities ( p <0.05), were less likely to have a university degree and higher income (both p <0.001), were less likely to be on oral hypoglycemic agents (OHA) ( p <0.001), had worse glycemic control parameters ( p = 0.463), were more likely to have positive urine microalbuminuria ( p = 0.019), and were less likely to be physically active ( p = 0.048) when compared to patients with no or milder degree of ED.

          Conclusion

          ED is highly prevalent in our study sample, with half of the patients having moderate to severe ED and being more likely to have depression. Older age, long-standing T2D, comorbidities, socioeconomic disadvantage, and sedentary lifestyle were all significantly associated with ED.

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          Most cited references40

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          Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis.

          Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes. To conduct a systematic review with meta-analysis of studies assessing the association between active smoking and incidence of type 2 diabetes. A search of MEDLINE (1966 to May 2007) and EMBASE (1980 to May 2007) databases was supplemented by manual searches of bibliographies of key retrieved articles, reviews of abstracts from scientific meetings, and contact with experts. Studies were included if they reported risk of impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes in relationship to smoking status at baseline; had a cohort design; and excluded persons with diabetes at baseline. Two authors independently extracted the data, including the presence or absence of active smoking at baseline, the risk of diabetes, methods used to detect diabetes, and key criteria of study quality. Relative risks (RRs) were pooled using a random-effects model. Associations were tested in subgroups representing different patient characteristics and study quality criteria. The search yielded 25 prospective cohort studies (N = 1.2 million participants) that reported 45 844 incident cases of diabetes during a study follow-up period ranging from 5 to 30 years. Of the 25 studies, 24 reported adjusted RRs greater than 1 (range for all studies, 0.82-3.74). The pooled adjusted RR was 1.44 (95% confidence interval [CI], 1.31-1.58). Results were consistent and statistically significant in all subgroups. The risk of diabetes was greater for heavy smokers (> or =20 cigarettes/day; RR, 1.61; 95% CI, 1.43-1.80) than for lighter smokers (RR,1.29; 95% CI, 1.13-1.48) and lower for former smokers (RR, 1.23; 95% CI, 1.14-1.33) compared with active smokers, consistent with a dose-response phenomenon. Active smoking is associated with an increased risk of type 2 diabetes. Future research should attempt to establish whether this association is causal and to clarify its mechanisms.
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            The Prevalence of Comorbid Depression in Adults With Diabetes: A meta-analysis

            To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes.
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              The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis.

              Erectile dysfunction (ED) shares similar modifiable risks factors with coronary artery disease (CAD). Lifestyle modification that targets CAD risk factors may also lead to improvement in ED. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of lifestyle interventions and pharmacotherapy for cardiovascular (CV) risk factors on the severity of ED. A comprehensive search of multiple electronic databases through August 2010 was conducted using predefined criteria. We included randomized controlled clinical trials with follow-up of at least 6 weeks of lifestyle modification intervention or pharmacotherapy for CV risk factor reduction. Studies were selected by 2 independent reviewers. The main outcome measure of the study is the weighted mean differences in the International Index of Erectile Dysfunction (IIEF-5) score with 95% confidence intervals (CIs) using a random effects model. A total of 740 participants from 6 clinical trials in 4 countries were identified. Lifestyle modifications and pharmacotherapy for CV risk factors were associated with statistically significant improvement in sexual function (IIEF-5 score): weighted mean difference, 2.66 (95% CI, 1.86-3.47). If the trials with statin intervention (n = 143) are excluded, the remaining 4 trials of lifestyle modification interventions (n = 597) demonstrate statistically significant improvement in sexual function: weighted mean difference, 2.40 (95% CI, 1.19-3.61). The results of our study further strengthen the evidence that lifestyle modification and pharmacotherapy for CV risk factors are effective in improving sexual function in men with ED.
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                Author and article information

                Journal
                J Multidiscip Healthc
                J Multidiscip Healthc
                jmdh
                Journal of Multidisciplinary Healthcare
                Dove
                1178-2390
                03 May 2024
                2024
                : 17
                : 2041-2051
                Affiliations
                [1 ]Professor of Medicine, Department of Medicine, Taif University , Taif, Saudi Arabia
                [2 ]Medical Intern, Department of Medicine, Taif University School of Medicine , Taif, Saudi Arabia
                [3 ]Consultant of Family Medicine and Diabetes, Diabetes and Endocrinology Center, Prince Mansour Military Hospital , Taif, Saudi Arabia
                [4 ]Consultant of Medicine and Endocrinology, Diabetes and Endocrinology Center, Prince Mansour Military Hospital , Taif, Saudi Arabia
                Author notes
                Correspondence: Khaled A Alswat, Dean of Graduate Studies, Associate Professor of Medicine, Department of Internal Medicine, Taif University School of Medicine, Airport Road, Taif, Al Huwaya, Saudi Arabia, Tel +127272020, Email K.alswat@tu.edu.sa
                Author information
                http://orcid.org/0009-0002-8267-7500
                http://orcid.org/0009-0007-9934-1348
                http://orcid.org/0009-0004-7805-5009
                Article
                455089
                10.2147/JMDH.S455089
                11075683
                38716372
                611d60a8-080e-460d-8fdb-d1b4b2ff2ebd
                © 2024 Alswat et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 15 December 2023
                : 16 April 2024
                Page count
                Figures: 0, Tables: 3, References: 41, Pages: 11
                Funding
                Funded by: There is no funding to report;
                There is no funding to report.
                Categories
                Original Research

                Medicine
                erectile dysfunction,ed,diabetes,t2d,depression,risk factors
                Medicine
                erectile dysfunction, ed, diabetes, t2d, depression, risk factors

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