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Erectile Dysfunction and Diabetes – Are you Screening?

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According to Annals of Family Medicine – Erectile Dysfunction is a marker for diabetes. Are you screening for this disease when asked about the little blue pill?

According to this study, erectile dysfunction had more than double the odds of having undiagnosed diabetes. For the average man aged 40 to 59 years, the predicted probability of having undiagnosed diabetes increased from 1 in 50 in the absence of erectile dysfunction to 1 in 10 in the presence of erectile dysfunction.

According to uptodate, the main factors associated with ED were peripheral or autonomic neuropathy, retinopathy, long duration of diabetes, and poor glycemic control.

Maintaining a healthy erection requires an increase in parasympathetic activity and a decrease in sympathetic activity – this allows for increased blood flow into the corpora cavernosa and a decrease in venous drainage.

So, nerve damage, impaired blood flow, and psychological factors can all affect an erection. It is to be noted that many men with diabetes also have depression. So, addressing both of these are important when treating erectile dysfunction.

According to Annals of Family Medicine, a complaint of erectile dysfunction should trigger a diabetic screening, especially in middle aged men. Other things to consider checking when a man complains of erectile dysfunction are: prolactin, testosterone, creatinine, and a lipid panel.

Strict glycemic control may prevent erectile dysfunction. But, there is no evidence that it will reverse the issue once it has occurred.  First line treatment includes PDE-5 inhibitors Рthese medications prolong the vasodilatory effects of nitric oxide.

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