Prevalence of Sexual Dysfunction and Its Related Factors in Male Japanese Patients with Diabetes
Authors: KONDO YUICHIRO , NAKAGAMI TOMOKO , OYA JUNKO , HASEGAWA YUKIKO , ITO ARATA , HIROTA NAOKI , TSUZURA REIKA , KATAMINE AKI , YOSHIMURA RAN , MIURA JUNNOSUKE , UCHIGATA YASUKO , BABAZONO TETSUYA 
Published: June 2018

Background: Sexual dysfunction affects the quality of life and is related to mortality among patients with diabetes (DM). The aim of the study was to assess the prevalence of erectile dysfunction (ED) and ejaculation disorder (EJD) and their related factors in male Japanese patients with DM.
Methods: This single-center, cross-sectional analysis was performed as a part of a study by our Diabetes Center between October 2013 and January 2014 (response rate, 91%). Of 7920 patients, women, patients with neither type 1 DM (T1D) nor type 2 DM (T2D), an unknown type of DM, and those for whom information was incomplete were excluded. The remaining male patients, 315 with T1D (49 ± 15 years) and 2732 with T2D (65 ± 12 years), were analyzed. They responded to questionnaires regarding subjective symptoms associated with diabetic complications, including ED and EJD, lifestyle, and depression symptoms (PHQ-9 score). A multivariable logistic regression model was used to examine factors related to ED and EJD.
Results: The prevalence of sexual dysfunction was significantly higher in patients with T2D (35.9%; ED + EJD 8.5%, only ED 25.8%, only EJD 1.7%) than in those with T1D (21.9%; ED + EJD 5.6%, only ED 12.2%, only EJD 4.1%). Multivariable logistic regression analysis showed that ED was independently associated with the presence of abnormal bowel movement and retinopathy in patients with T1D and age, the presence of proliferative retinopathy (PDR), heart failure, frequent urination, dysuria, dysautonomia, long sleeping hours, and a high PHQ-9 score in those with T2D. EJD was independently associated with PDR in patients with T1D and T2D and the presence of dysautonomia, frequent urination, dysuria, and abnormal bowel movement in patients with T2D.
Conclusions: Sexual dysfunction is not rare in male Japanese patients with DM. In daily clinical practice, attention should be paid to patients at a high risk of sexual dysfunction with a variety of complicated symptoms and conditions due to DM.

Disclosure
Y. Kondo: None. T. Nakagami: None. J. Oya: None. Y. Hasegawa: None. A. Ito: None. N. Hirota: None. R. Tsuzura: None. A. Katamine: None. R. Yoshimura: None. J. Miura: None. Y. Uchigata: None. T. Babazono: Research Support; Self; Abbott, Arkray, Inc.. Speaker's Bureau; Self; Asahi Kasei Corporation, AstraZeneca. Research Support; Self; Baxter, Becton, Dickinson and Company, Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Eli Lilly and Company. Research Support; Self; Kowa Pharmaceuticals America, Inc., Kissei Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., MSD K.K., Nippon Boehringer Ingelheim Co. Ltd.. Board Member; Self; Japan Diabetes Society. Research Support; Self; Johnson & Johnson Diabetes Institute, LLC., Novartis Pharma K.K., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd.. Speaker's Bureau; Self; Otsuka Holdings Co., Ltd.. Research Support; Self; Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Takeda Canada Inc., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceuticals U.S.A., Inc., Teijin Pharma Limited, Terumo Medical Corporation.