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Issue 216 Item 6 Sildenafil Treatment Less Effective in Men With Diabetes

Oral sildenafil is only moderately effective in the treatment of erectile dysfunction in patients with diabetes.

"The response rate was lower and cardiovascular events were higher than previously reported in nondiabetic patients," writes M. R. Safarinejad, MD, Department of Urology, Military University of Medical Sciences, Tehran.

A total of 282 men (mean age 46.4 years) with erectile dysfunction (mean duration 3.6 years) and diabetes (mean duration 11 years) were recruited for this randomised, double-blind, placebo-controlled trial.

Over the 16-week study period, 144 men were assigned to receive sildenafil 100 mg approximately 1 hour before sexual activity and 138 men received a matching placebo.

Treatment efficacy was evaluated using the International Index of Erectile Function questionnaire. Ninety-three percent of men in the sildenafil group and 93% of men in the placebo group completed the study.

The investigator reports positive clinical results in 51% of men in the sildenafil group compared with 11% of men in the placebo group (P < .003). In the sildenafil group, 59% of men noted at least 1 successful attempt at sexual intercourse compared with 21% of men in the placebo group (P < .002).

Adverse effects were reported by 22 % of men treated with sildenafil compared with 3 % of men in the placebo group. The most frequently reported adverse events were: headaches (sildenafil: 20%, placebo: 2%), flushing (sildenafil: 19%, placebo: 0%), rhinitis (sildenafil: 6%, placebo: 0%), and cardiovascular events (sildenafil: 7%, placebo: 0%).

Two percent of patients treated with sildenafil reported new chest pain; myocardial infarction was documented in half of those patients. J Diabetes Complications 2004 Jul-Aug;18:4:205-10

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DID YOU KNOW: English students who underwent an education program reduced the number of non-diet drinks they consumed, which resulted in reduced numbers of overweight and obese children. The school-based program encouraged 644 students, aged 7 to 11, to curtail their soda drinking. After only 3 days, the consumption of carbonated drinks decreased in the intervention group but increased in the control group. After 12 months, there was a 7.5% increase in overweight and obese children in the control group, while this number was decreased by 0.2% in the intervention group. BMJ April 27, 2004