Etiology and Risk Factors of Erectile Dysfunction: Diabetes Part 2, Metabolic Syndrome

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A large national epidemiologic study was able to review a very large database of the diabetic male population through the use of managed care claims.

The study used this database to determine the prevalence of diabetes in men with and without ED. The prevalence of diabetes in men with ED was found to be much higher than the general population. Twenty percent of men suffering from ED were also found to have been diagnosed with diabetes; this is in comparison to only 7.5% in men without ED – to treat erectile dysfunction try cheap australia viagra online.

Given this finding that men with ED are twice as likely to have diabetes as those without ED, the diagnosis of ED may indeed serve as a useable marker for diabetic screening. A similarly large national study in 2005 evaluating men with ED found four specific comorbidities to be significantly prevalent among men carrying the diagnosis of ED. The authors even suggested that ED may be used as an observable marker for all four: hypertension, hyperlipidemia, depression, and diabetes Although treatment of ED is discussed later in the book, it is prudent to mention here that certain trials in the past decade have been specifically dedicated to the treatment of ED in diabetic males. A retrospective analysis of data from twelve placebo-controlled trials evaluated the efficacy and safety of tadalafil for the treatment of ED in diabetic males. They confirmed that diabetic men have more severe ED than controls at baseline. Interestingly, they also found that baseline erectile function in the diabetic males correlated inversely with baseline HbA(1)c levels. They concluded that although ED was found to be more severe in the diabetic population, response to tadalafil was only slightly lower than controls for the treatment of ED. Metabolic Syndrome An estimated 47 million people in the USA have metabolic syndrome.

Metabolic Syndrome is a combination of medical disorders thatincrease an individual’s risk for CAD and diabetes. Components of the syndrome include abdominal obesity, atherogenic dyslipidemia, hypertension, insulin resistance, prothrombotic states, and proinflammatory states. Correlation between metabolic syndrome and ED has been well established and mirrors the association of CAD or diabetes with the syndrome. Reported prevalence of ED in patients with metabolic syndrome falls between 26.7% and virtually 100%, and this prevalence increases as the number of components of the metabolic syndrome increases.

Of mention, hyperhomocysteinemia is an emerging risk factor for the development of ED in diabetic men. Further studies are needed to evaluate the exact mechanism by which this metabolite exerts its effect.


Etiology and Risk Factors of Erectile Dysfunction: Diabetes

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The pathophysiology of ED in men with diabetes mellitus (DM) is complex and multifactorial. Men with DM, even those without significant comorbidities, suffer from a wide range of sexual dysfunction, including decreased desire and sexual satisfaction.

Prevalence of ED among diabetic men that has been reported in the literature ranges widely. Unfortunately, many studies either have not differentiated between DM Type 1 and Type 2, or were not done in Type 1 diabetics. The prevalence of ED among men with DM in the MMAS was reported at three times the general population, or 28% versus 9.6%. A more recent study evaluated selfreported ED in males with DM Type 1 and found a prevalence of 20% overall and 47.1% in those 43 years of age or older. Along with objective factors, such as decreased libido, men with DM Type 2 demonstrate organic causes with a decreased nocturnal penile tumescence.

Several cellular and molecular derangements have been described in diabetic men that contribute to the increased risk of ED in this population. Vascular injury is an important cause of ED in this population. At gross anatomical level, men with diabetes have an increased prevalence of cavernosal arterial insufficiency, thus impaired arterial response, on ultrasound.

erectile-dysfunction-diabetes1An early study reported impaired endothelial-mediated vasodilation upon exposure to acetylcholine, a parasympathetic agent, in cavernosal tissue of diabetic men with ED.

Since this study, endothelial dysfunction in cavernosal tissue of diabetic men has been characterized by abnormalities including, but not limited to, increased apoptosis, oxidative stress, and overactivity of protein kinase C.

Thus, the effect of DM on penile vasculature is mechanically similar to its effect on other vascular structures throughout the body. Although advanced glycation endproducts have been demonstrated in cavernosal tissue, their significance remains unclear.While a majority of research has focused on diabetic ED as vascular phenomenon, there is at least correlational evidence that autonomic neuropathy plays a role in the development of ED in diabetics. The existence of ED in men with diabetes is also predicted by age and other complications of diabetes, such as retinopathy and depression


Diabetic Erectile Dysfunction

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For men suffering from type 2 diabetes, life is difficult enough without the added frustration and embarrassment of experiencing sexual problems and erectile dysfunction. Erectile dysfunction can be described as a consistent inability to have an erection firm enough to have sexual intercourse. Estimates of the number of males that suffer from this condition vary from as low as 20% to as high as 70%. Because of the embarrassment associated with this dysfunction, nobody can be sure what an accurate percentage could be.

Diabetic men are three to four more times more likely to suffer from erectile dysfunction than the average non-diabetic man. It is difficult to make the connection between erectile dysfunction and pre-diabetes, as most people with pre-diabetes are unaware of their condition. Aware or not, pre-diabetes problems can affect erectile dysfunction.

Erectile dysfunction is a problem with the nervous system. It is believed that diabetes and high blood sugar levels can damage nerves, which seems to lead to the erectile dysfunction. It is also important to factor in that high blood sugar levels play in altering hormone production. This altered hormone production can cause a male to take on more female hormone characteristics. This means that a male could have increased estrogen levels and decreased testosterone level because of diabetes and high blood sugars. With decreased testosterone levels, the male will experience a low sex drive and an inability to get and sustain an erection.

Most men with erectile dysfunction use medication to correct their problem. Using medication may be an effective to improve ‘performance,’ but it really does nothing to fix the cause of the real problem. Medications in general are an effective way to help certain conditions like blood flow, they rarely get to the root cause of the problem.

If the real problem is high blood sugar levels, then it is very important to get them under control. Too many people suffering from type 2 diabetes do not make an effort to get their blood sugar under control. Instead of doing the education needed for their condition, they are given medication after medication. This is not as effective as it needs to be, and so there has to be another way.

If you, or someone you know is, or thinks they may be a type 2 diabetic, please see a physician as soon as possible and have tests done so you learn exactly what you are dealing with. Type 2 Diabetes is a very serious disease and if left untreated can create serious permanent damage. Go get treated today, you deserve the very best!