NEW YORK (Reuters Health) - Erectile dysfunction, or impotence, is common in men with type 2 diabetes and is associated with a poorer quality of life, as well as a higher level of depressive symptoms, according to researchers.

``Our data show that erectile dysfunction is a very common problem, affecting one third of patients with type 2 diabetes,'' lead investigator Dr. Antonio Nicolucci of the Consorzio Mario Negri Sud in Santa Maria Imbaro, Italy, told Reuters Health in an interview.

In the US, complete erectile dysfunction occurs in about 10% of men between 40 and 70 years old, he noted. Men with type 2 diabetes are known to have a higher rate of impotence and to develop erectile dysfunction at an earlier age.

Achieving an erection requires increased blood flow into two spongy chambers in the penis. But arterial disease, common in patients with heart disease and diabetes, can lead to reduced blood flow into the penis.

To determine how common erectile dysfunction is in diabetic men and to study its effect on their quality of life, Nicolucci's research team assessed erectile function in 1,460 men with type 2 diabetes. All answered a battery of questions on various quality of life issues such as depression, social functioning and sex life satisfaction.

``Overall, 34% of the patients reported frequent erectile problems, 24% reported occasional problems, and 42% reported no erectile problems,'' the authors write in the February issue of Diabetes Care.

``Our study also documented that erectile dysfunction has a big impact on quality of life and is responsible for higher levels of frustration and discouragement and a lower acceptance of diabetes, which were in turn related to worse blood glucose levels,'' Nicolucci stated.

``Erectile dysfunction was also associated with higher levels of depressive symptoms,'' he added. ``In fact, in our (study), almost two thirds of the patients reporting erectile problems also had severe depressive symptoms.''

Despite its great impact on quality of life, Nicolucci and his team report that many doctors don't take a patient's sexual function into consideration. Sixty-three percent of the men in the current study said their physicians had never asked them whether they had any sexual problems.

As expected, patients with erectile dysfunction reported a worse quality of sexual life, but one third of them said diabetes had no impact on their sex life, according to Nicolucci.

The lack of knowledge of the relationship between diabetes and sexual problems, as well as misinformation and embarrassment, may help explain why diabetic men with erectile dysfunction did not seek treatment, he noted.

Still, Nicolucci encourages patients to discuss sexual problems with their physicians. He noted that many successful and reasonably safe treatments for impotence are available. Adequate psychological support, he added, can help men with depressive symptoms.

``As for all diabetes complications, a tight blood glucose control can reduce or delay the incidence of sexual problems,'' Nicolucci advised.

``It is therefore particularly important to follow medical recommendations regarding diet, physical activity and treatments,'' he concluded.

SOURCE: Diabetes Care 2002;25:284-291.

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