DIABETES-MELLITUS AND MALE SEXUAL FUNCTION - A CONTROLLED-STUDY

There is an extensive clinical literature on the erectile disorders of diabetic men but a paucity of controlled studies that have taken into account the effects of age, concurrent illnesses and medication on se xual function. This investigation was carried out on 40 diabetic men f ree from other illness or drugs that could affect sexual capacity and 40 age-matched healthy control subjects. Each subject and his female p artner underwent semistructured interviews and the men had comprehensi ve medical evaluations and polygraphic assessment of sleep and nocturn al penile tumescence in the sleep laboratory during three nights. In c omparison to control subjects, diabetic patients reported significant decreases in sexual desire, subjective arousal, erectile capacity, coi tal frequency and sexual satisfaction. The diabetic group also had sig nificant decrements in duration of rapid eye movement sleep and in fre quency, duration and degree of nocturnal penile tumescent episodes. Th ere were no differences between Type 1 (insulin-dependent) and Type 2 (non-insulin dependent) diabetic patients in prevalence of sexual prob lems or in nocturnal tumescent measures. Significant relations were ob served between lack of metabolic control, diabetic complications and i mpaired nocturnal tumescence. Sexually non-dysfunctional diabetic men had significant nocturnal penile tumescence abnormalities. Diabetic me n without coital failures may have a subclinical impairment in erectil e function which, although of not significant magnitude to interfere w ith penetration, is reflected in nocturnal penile tumescent measures. This result raises a note of caution in the interpretation of the noct urnal penile tumescence test for the differential diagnosis of diabeti c erectile impotence.