Sexual dysfunction, metabolic syndrome in relation to cardiometabolic risk factors and sexual quality of life of Ghanaian type 2 diabetics and their partners

Diabetes mellitus is a chronic disease that can result in various medical, psychological, metabolic and sexual dysfunctions (SD) if not properly managed. SD in both men and women is a common under-appreciated complication of diabetes and it is complicated with the development of dyslipidaemia as a result of the metabolic syndrome. Less attention has been given to female sexual health and its impact on their quality of life as well as that of their partners. This study assessed the determinants of SD, MetS, SD/Mets and SQoL among diabetic patients in Tema, Greater Accra Region of Ghana. Sexual dysfunction and metabolic syndrome was determined consecutively in 130 diabetic males (age range: 29-89 years) and 116 diabetic females (age range: 33-78 years) visiting the diabetic clinic of Tema General Hospital between September, 2012 and October, 2013 using the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire for males (GRISS-M) and females (GRISS-F) and the WHO, NCEP- ATP III and IDF criteria respectively. In addition to the socio-demographic characteristics of the participants, FBG, lipid profile, total testosterone, bioavailable testosterone, free testosterone, percentage bioavailable testosterone, percentage free testosterone, SHBG, adiponectin, leptin and insulin levels were assessed. All the diabetic participants and their partners had a steady heterosexual relationship for at least 2 years before enrolment in the study. Out of the 150 diabetic male participants contacted, the response rate was 86.7% after 5 declined participation and 15 incomplete data were excluded. Out of the 150 diabetic female participants contacted, the response rate was 82.9% after 10 declined participation and 24 incomplete data were excluded. For both male and female diabetic respondents, majority were married, with males recording a 95.4% marital rate and females recording a marital rate of 91.45 %. The minority of both diabetic males as well as females had attained higher education with the males recording a higher education rate of 6.15% and the females recording 1.72 %.The prevalence of SD was recorded as 64.62% among diabetic males and 66.38% in diabetic female participants. The prevalence of MetS by the NCEP-ATP, IDF and WHO criteria for the male diabetics was 32.31%, 46.15%, 64.62% respectively and63.79%, 56.03%, 60.34%respectivelyfor the diabetic females. The mean BMI of the diabetic respondents was 28.88 ± 11.32 kg/m2 for the males and 32.7 ± 16.15 kg/m2 for the females. Minority of the males (21.54 %) and females (6.03 %) were consumers of alcoholic products and none were smokers. Ageing was found to be a very important factor in the development of SD in both diabetic males and females and is likely to affect the SQoL of both sexes. Longer DOD however is more likely to affect diabetic men, worsening their SQoL as well as that of their partners. Diabetic females on the other hand are less likely to be affected by a longer DOD and this is less likely to affect their SQoL but affects the SQoL of their partners as a result of unresponsiveness to sexual advances by these diabetic females. Diabetic females with a higher perception of adequate IELT have male partners with a lower SQoL-P scores. The determinants of SD amongst diabetic females were more likely to be related to psychogenic and social factors as opposed to their male counterparts possibly due to potentially more stringent haemodynamic and energy requirements involved in sexual functioning in males. The determinants of MetS among diabetic male participants were low HDL-cholesterol, bioavailable and free testosterone levels with a 0.130, 4 and 3 times risk of developing the MetS. Hypogonadism provided a higher risk to the development of MetS than dyslipidaemia and is potentially an earlier risk factor in the pathogenesis of diabetes or the MetS.

Source: KNUST