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How Vascular Dysfunction Contributes to Diabetes

Studies show sexual dysfunction in patients with 50+ years of diabetes….

In this study, 301 males were used in the Medalist Study, individuals with an average duration of 55 years of type 1 diabetes. A self-assessment was used to report sexual problems with CVD. Cardiovascular disease was based on the history of coronary artery disease, angina, heart attack, bypass graft surgery, or leg angioplasty. Sexual dysfunction was validated through the International Index of Erectile Dysfunction (IIEF). The IIEF was a questionnaire that was sent to individuals to assess the sexual dysfunction. An IIEF score ≤17 was considered as having erectile dysfunction.

Results showed 69.8% of participants experiencing SD during their lifetime. In those that reported SD, the mean BMI and HbA1c were higher. The HDL levels were lower and the total cholesterol was higher in those patients without SD.

The authors concluded there is a connection between erectile dysfunction and cardiovascular disease. They believe the vessels feeding blood to the penis are smaller than the ones feeding blood to the heart. The inhibition of nitric oxide prevents the dilation of arteries which impairs the blood flow. There could have been limitations to the history of SD due to social, economic, or lifestyles of the participants. There was no correlation observed between the duration, glycemic control, age, and lipid profile with microvascular complications. But there was a CVD correlation with HbA1c, age, duration, lipid profile, and inflammatory markers.

Practice Pearls:
  • Type 1 diabetes characterized with low levels of microvascular complications.
  • CVD is the leading cause of morbidity and mortality in diabetics.
  • Type 1 diabetes is usually leaner and has elevated HDL levels compared to T2DM.   

Diabetes Care October 2013