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Diabetes, Sexual Dysfunction and Cardiovascular Disease: A Connection

Diabetes, erectile dysfunction and cardiovascular disease

Men who have type 1 diabetes and who are experiencing problems with sexual dysfunction actually may be showing indications that something else is amiss. Results of a new study indicate that sexual dysfunction may be a sign of cardiovascular disease in type 1 diabetic patients.

Sexual dysfunction may predict heart problems

The link between sexual dysfunction and type 2 diabetes has been recognized for many years, and according to a recent study published in Postgraduate Medicine Journal, few individuals are diagnosed and treated for this combination of conditions. Given that the prevalence of diabetes is increasing and expected to grow dramatically, the number of men with sexual dysfunction will likely increase as well.

Sexual dysfunction, and especially erectile dysfunction in men, is increasingly being recognized as an early indicator of other systemic diseases, such as heart disease. In a 2011 study, for example, Italian researchers evaluated the association between levels of testosterone and risk of cardiovascular disease in men with erectile dysfunction, and the role of obesity.

They observed that low testosterone could be associated with either an increased or reduced risk of cardiovascular disease, depending on certain characteristics of the men. Specifically, they found that low testosterone in obese men might represent a greater risk of cardiovascular disease.

At the 72nd Scientific Sessions of the American Diabetes Association, Sara Turek, MPH, of the Joslin Diabetes Center in Boston, reported on what she and her colleagues found concerning sexual dysfunction and cardiovascular disease among 301 men from the 50-Year Medalist Study.

The 50-Year Medalist Study is an ongoing project that includes men who have had type 1 diabetes for more than 50 years. While previous research has shown that Medalists have a diabetes complications rate that is less than that seen among others who have type 1 diabetes, including eye disease, their rate of cardiovascular disease is similar to that among people with type 2 diabetes.

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In the current study, Turek and her team examined the prevalence of sexual dysfunction among the Medalists. Nearly three-quarters (69.8%, or 210 of 301) of the Medalists responded in the affirmative to the question "Have you ever had sexual problems?"

When the researchers compared other factors between the two groups (men reporting sexual dysfunction vs those not reporting this problem), they found the mean figures to be similar, respectively. For example:

  • Hemoglobin A1c was 7.1% vs 6.8%
  • Body mass index was 26.1 kg/m2 vs 25.8 kg/m2
  • Total cholesterol was 159.3 mg/dL vs 150.1 mg/dL
  • High density lipoprotein was 55.1 mg/dL vs 62.1 mg/dL
  • Inflammatory markers commonly associated with risk of cardiovascular disease, namely C-reactive protein and plasminogen activator inhibitor type 1, were similar

The investigators did find that a history of smoking cigarettes was associated with sexual dysfunction: 51.7% in the sexual dysfunction group smoked versus 39.3% in the non-sexual dysfunction group. (Smoking is a risk factor for erectile dysfunction.) In addition, the inflammatory marker interleukin 6 (IL-6) was significantly associated with reports of sexual dysfunction.

According to Turek, "The clinical message is that sexual dysfunction might be a more overt sign of cardiovascular issues of future cardiovascular issues than other clinical markers of cardiovascular disease symptoms such as hypertension, high cholesterol, and atherosclerosis."

The take-home message? Men with diabetes who are experiencing sexual dysfunction should tell their doctors, and physicians should ask about sexual problems and screen for cardiovascular problems in men with diabetes since erectile dysfunction may help predict an increased risk of cardiovascular problems in this population.

Corona G et al. Testosterone and cardiovascular risk in patietns with erectile dysfunction. Journal of Endocrinological Investigation 2011 Nov 8
Isidro ML. Sexual dysfunction in men with type 2 diabetes. Postgraduate Medicine Journal 2012 Mar; 88(1037): 152-59
Stein, Jill. Sexual dysfunction may be a tip-off to heart disease in diabetic men. Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/248112.php.

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