With increasing age, men may experience erectile dysfunction. However, a diabetes condition can additionally increase this risk. The fact that erectile dysfunction occurs more frequently in type 2 diabetes than in type 1 diabetes now captured the interest of researchers at the German Diabetes Center (DDZ), a partner of the German Center for Diabetes Research. The aim was to determine how common erectile dysfunction is in the novel subgroups of diabetes and what conclusions can be drawn from this for possible therapies.
There is now increasing consensus among scientists that diabetes can not only be differentiated between type 1 and type 2 diabetes, but rather between five subgroups, some of which can have very different effects on those affected. These five subgroups can be classified as follows:
- Severe autoimmune diabetes (SAID); corresponds to classic type 1 diabetes
- Severe insulin-deficient diabetes (SIDD)
- Severe insulin-resistant diabetes (SIRD)
- Mild obesity-related diabetes (MOD)
- Mild age-related diabetes (MARD)
"People with insulin-deficient diabetes, for example, are more likely to show disturbed pain sensations such as tingling or numbness in their hands and feet, while those with severe insulin-resistant diabetes are at higher risk of liver and kidney disease," said Prof. Dr. Michael Roden, scientific director and executive board member of the DDZ. "The aim of our new study was therefore to characterize the prevalence of erectile dysfunction in these five subgroups of diabetes." For this purpose, more than 350 men aged 18 to 69 years with recent-onset diabetes were assessed as part of the German Diabetes Study. An additional 124 men from the German Diabetes Study without diabetes were included as a control group.
First of all, the study showed that 23 percent of all men with diabetes suffered from erectile dysfunction, compared with only 11 percent of men without diabetes. Compared with the subjects without erectile dysfunction, the affected subjects were also older, had a higher body mass index (BMI), higher triglyceride levels and lower cholesterol levels. "Interestingly, however, the prevalence of dysfunction was highest in subjects with severe insulin-resistant diabetes (SIRD), at 52 percent. By contrast, at seven percent, the prevalence was lowest in subjects with severe autoimmune diabetes (SAID),“ said Dr. Haifa Maalmi, a research associate in the research group Inflammation of the DDZ, summarizing the results. "This suggests that the prevalence of erectile dysfunction differs between diabetes subgroups of diabetes."
Since, in addition to the SIRD subgroup, the SIDD subgroup also has a relatively high risk of erectile dysfunction in men, insulin deficiency as well as insulin resistance can be considered as significant factors. "Therefore, the next step should be to specifically investigate these two subgroups for erectile dysfunction," said Professor Christian Herder, MD, deputy director at the Institute for Clinical Diabetology. "If the underlying mechanisms are better understood here, therapies can also be more targeted."
Maalmi H, Herder C, Bönhof G, Strassburger K, Zaharia OP, Rathmann W, Burkart V, Szendroedi J, Roden M, Ziegler D, GDS-Group: Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes. Diabetologia 2022; 65(3):552–562. DOI: 10.1007/s00125-021-05607-z