Incidence of erectile dysfunction in Italian men with diabetes

Purpose: We determined the incidence of erectile dysfunction in Italian men with diabetes. Materials and Methods: We estimated the incidence of erectile dysfunction, defined as failure to achieve and maintain erection sufficient for satisfac tory sexual performance, after 2.8 years of followup in 1,010 men enrolled for a prevalence study of erectile dysfunction in diabetes. Results: Of the 1,010 men 192 (19%) complained of erectile dysfunction. The crude incidence rate of erectile dysfunction was 68 cases per 1,000 person -years (95% confidence interval 59 to 77). The incidence of erectile dysfun ction increased with increasing age (10-fold higher for ages 70 to 79 than for 19 to 29 years), duration of diabetes (1.6-fold higher a history of 11 years or greater than for less than 5) and deteriorating metabolic control (1.7-fold higher for hemoglobin Alc greater than 9% than less than 7.5%). M oreover, it was higher in type 2 than in type I diabetes (74 versus 45 case s per 1,000 person-years). The relative risk was 1.75, 2.02, 1.97, 1.16, 1. 86, 3.79 and 1.52 for associated obliterative arterial disease of the lower legs, ischemic heart disease, renal disease, autonomic neuropathy, sensiti ve and motor neuropathy, diabetic foot and retinal disease, respectively. O f the characteristics at study enrollment patient age, duration of diabetes , renal disease and hypertension were multivariate predictors of the erecti le dysfunction 2.8 years later. Conclusions: The incidence of erectile dysfunction in Italian men with diab etes at a mean followup of 2.8 years was 68 cases per 1,000 person-years, m ore than 2-fold that in the Massachusetts Male Aging Study of the general p opulation. The knowledge of this incidence should promote specific preventi ve and therapeutic interventions for erectile dysfunction in men with diabe tes.