Diabetic Neuropathy Raises Risk of Erectile Dysfunction and Urinary Problems

Men with type 1 diabetes with diabetic peripheral neuropathy (DPN) have an increased occurrence of erectile dysfunction and lower-urinary-tract symptoms, according to a new analysis of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC).

Researchers found that men with type 1 diabetes and DPN were four times more likely to experience erectile dysfunction, nocturia, frequency, urgency, weak urinary stream, intermittency, straining, and/or the sensation of incomplete emptying than men without neuropathy.

The EDIC study is a follow-up to the DCCT, in which patients with type 1 diabetes randomized to tight glycemic control had lower rates of retinopathy, neuropathy, and nephropathy compared to patients randomized to conventional treatment. Since the DCCT’s end, the glycemic control of the two groups has equalized.

Researchers analyzed 635 men who had participated in the DCCT and continue to be followed in the EDIC. At the time of the analysis, they had a mean age of 52 and had type 1 diabetes for 30 years with a mean HbA1C of 7.9%. Researchers looked at a combination of symptoms and examination findings to confirm which men had DPN in addition to type 1 diabetes.

Overall, 30% of the patients reported only erectile dysfunction, 10% reported only lower-urinary-tract symptoms, and 15% reported both. Among those who had DPN, those proportions were 41%, 31%, and 62%, respectively. Researchers stressed that physicians should ask patients about these complications, which can greatly affect quality of life.

The data, from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC), were presented September 13 at Neurodiab, the annual meeting of the Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes, by Rodica Pop-Busui, MD, PhD, associate professor of internal medicine, metabolism, endocrinology, and diabetes and codirector of the Neuropathy Center at the University of Michigan, Ann Arbor.

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