MP32-02 BURDEN AND CHARACTERISTICS OF DECREASED SEXUAL DESIRE AND ORGASMIC DYSFUNCTION IN MEN WITH TYPE 1 DIABETES IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL/EPIDEMIOLOGY OF DIABETES INTERVENTIONS AND COMPLICATIONS STUDY (DCCT/EDIC)

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 2014MP32-02 BURDEN AND CHARACTERISTICS OF DECREASED SEXUAL DESIRE AND ORGASMIC DYSFUNCTION IN MEN WITH TYPE 1 DIABETES IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL/EPIDEMIOLOGY OF DIABETES INTERVENTIONS AND COMPLICATIONS STUDY (DCCT/EDIC) Bahaa S. Malaeb, Sara M. Lenherr, Hunter B. Wessells, Barbara Braffett, Patricia Cleary, Rodney Dunn, Alan Jacobson, and Aruna V. Sarma Bahaa S. MalaebBahaa S. Malaeb More articles by this author , Sara M. LenherrSara M. Lenherr More articles by this author , Hunter B. WessellsHunter B. Wessells More articles by this author , Barbara BraffettBarbara Braffett More articles by this author , Patricia ClearyPatricia Cleary More articles by this author , Rodney DunnRodney Dunn More articles by this author , Alan JacobsonAlan Jacobson More articles by this author , and Aruna V. SarmaAruna V. Sarma More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.932AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Studies of male sexual dysfunction in patients with diabetes focus primarily on erectile dysfunction (ED). The current study aimed to determine the burden and characteristics of low sexual desire (SD) and orgasmic dysfunction (OD) in men with type 1 diabetes enrolled in the DCCT/EDIC. METHODS The study cohort consisted of men enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) Study, the observational follow up of participants of the Diabetes Control and Complications Trial (DCCT). In 2003 (EDIC year 10), we conducted an ancillary study of urologic complications and assessed sexual function using the validated International Index of Erectile Function (IIEF). In 2010 (EDIC year 17) we re-evaluated sexual function in 664 men. Low SD, defined by frequency and level of sexual desire, and OD, defined by frequency of ejaculation and feeling of orgasm with our without ejaculation, were defined using standard cutoffs of domain specific scores. Socio-demographic, clinical and diabetes characteristics were compared by SD and OD status. RESULTS Overall, 243 (42%) and 83 (15%) men reported low SD and OD at EDIC 17, respectively. 42 (8%) men report both low SD and OD. The prevalence of OD and low SD was not significantly different between the intensive versus conventional treatment group. Low SD and OD were most strongly associated with older age, less engagement in sexual activity, decreased physical function and presence of ED. Low SD was not associated with low testosterone concentrations. Orgasmic dysfunction was also significantly associated with several characteristics including: HTN, smoking, low testosterone, peripheral and autonomic neuropathy, nephropathy, moderate to severe lower urinary tract symptoms, and higher Hg A1c level (see Table). CONCLUSIONS Findings suggest that patients with long standing type I diabetes may suffer from a high burden of low SD and OD. Markers of diabetes progression were strongly associated with orgasmic dysfunction. These data suggest that the potential pathophysiological impact of diabetes progression on sexual dysfunction requires further investigation. Studies with non-diabetic control group are warranted. Characteristics of the study population by prevalent cases of low sexual desire (SD) and orgasmic dysfunction (OD) at EDIC year 17 Low SD (n=243) Normal SD (n=355) p value OD (n=83) No OD (n=481) p value Age (years) 52.5 ± 6.4 50.8 ± 6.5 0.001 53.5 ± 6.2 50.8 ± 6.5 0.001 Engaged in sexual activity 204 (84) 333 (94) < 0.0001 71 (86) 456 (95) 0.001 BMI (kg/m2) - Normal <25 59 (25) 63 (18) 0.6 17 (22) 99(21) 0.5 - Overweight 25-29 90 (38) 165 (48) 30 (38) 214 (45) - Obese 30+ 89 (37) 119 (34) 31 (40) 161 (34) Hypertension 168 (70) 243 (69) 0.9 64 (78) 319 (67) 0.04 Test <300 ng/dl 24 (10) 28 (8) 0.4 11 (14) 34 (7) 0.04 Smoking 27 (11) 177 (50) 0.7 15 (18) 48 (10) 0.03 Intensive Treatment Arm 119 (49) 7.9±0.9 0.8 40 (48) 243 (51) 0.7 DCCT/EDIC HbA1c 7.9±1.0 7.9±0.9 0.9 8.2±1.0 7.8±0.9 0.004 Moderate/Severe LUTS 58 (24) 82 (23) 0.8 36 (43) 99 (21) < 0.0001 SF36 Physical Component Score 85.9 ± 18.9 90.6 ± 16.0 0.0008 77.0 ± 21.6 91.4 ± 14.8 < 0.0001 SF36 Mental Component Score 79.4 ± 14.6 80.5 ± 16.2 0.08 73.0 ± 18.3 81.6 ± 14.6 < 0.0001 Nephropathy (AER=300 mg/24hr or ESRD) 13 (6) 24 (7) 0.4 11 (14) 25 (5) 0.0002 Neuropathy (Abnormal MNSI)# 106 (45) 139 (40) 0.3 47 (59) 183 (39) 0.0008 Cardiovascular Autonomic Neuropathy ## 92 (39) 116 (33) 0.2 43 (54) 154 (33) 0.0003 Erectile Dysfunction 92 (38) 71 (20) < 0.0001 55 (66) 93 (19) < 0.0001 Data presented as means (SD) or n (%), # Neuropathy defined as an abnormal MNSI by the Michigan Neuropathy Screening Instrument >6 on questionnaire or >2 on exam. ## CAN function defined as either R-R variation<15 or R-R variation between 15-19.9 plus either a Valsalva ratio=1.5 or a supine-to-standing drop of 10 mm Hg in diastolic blood pressure at EDIC year 16/17. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e331 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Bahaa S. Malaeb More articles by this author Sara M. Lenherr More articles by this author Hunter B. Wessells More articles by this author Barbara Braffett More articles by this author Patricia Cleary More articles by this author Rodney Dunn More articles by this author Alan Jacobson More articles by this author Aruna V. Sarma More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...