Erectile dysfunction (ED) is the persistent inability (over a period of 3 months or longer) to get or keep an erection adequate for sexual activity. It is estimated to affect more than 150 million men worldwide and up to 30 million in the United States. Erectile dysfunction is increasingly being recognized as an early marker for diabetes. Current clinical research is supporting the concept that ED could detectment at pre-diabetic stage characterized by the presence of insulin resistence, metabolic syndrome, impaired fasting glucose or glucose intolerance.
Discussing ED (with patients):
Although diabetes is not the only cause of ED, research has shown that men with erectile dysfunction are twice as likely to have diabetes, compared to men without ED. Unfortunately, many men believe that ED occurs when they cannot get any type of erection, thus physicians often miss an opportunity for early detection and management of diabetes and other chronic medical conditions.
Some patients may not be as comfortable initially sharing changes in their sexual performance with their provider. Erectile dysfunction and sexual health may be an important motivating force that will help diabetic men change behaviors and embrace both the lifestyle interventions and medical management needed to improve their overall care. It is likely that ED is more prevalent at younger ages in African American men given the increased prevalence of diabetes, hypertension and other risk factors. For these reasons, the NMA Diabetes Education Program is encouraging physicians to ask their male patients questions about their sexual health by discussing the correlation between ED and diabetes.
Here are some suggested questions to ask your patient:
- “Have you noticed any changes in your sexual performance?”
- “Have you noticed more difficulty, over the past several months to a year, being able to keep a firm erection during intercourse?”
- “Do you feel that you lose your erection too quickly during intercourse.
The Diabetes Education Program:
The NMA Diabetes Education Program, funded by a five year cooperative agreement from the Centers for Disease Control and Prevention (CDC), is in the fifth year of grant activities. To address the disproportionate prevalence of diabetes in the Black community, the program has six coalition sites conducting diabetes outreach and education in their respective communities. The coalition cities are Atlanta, Houston, Indianapolis, Los Angeles, Pine Bluff (Arkansas), and Washington (District of Columbia) (Objective #1). The Program continues to focus on three educational objectives including:
- Provide outreach, such as risk assessments, community workshops, and media campaigns. (Objective #2).
- Educate diabetic patients about preventing behaviors, as well as healthy disciplines to maintain good health while affected by the disease (Objective #3).
- Educate NMA physicians (Objective #4)
Portions of this article we’ve contributed: by Kevin Billups, MD; Associate Professor of Urology; University of Minnesota; Staff Urologist; VA Medical Center; Minneapolis, MN and co-written by NMA Diabetes Education Program team.
The NMA Diabetes Education Program is coordinated by Wilma J. Wooten, M.D., M.P.H., Principal Investigator; Ivonne Fuller, N.R.P.P., M.P.A. Program Administrator; and Roslyn A. Douglas, M.A., Program Coordinator. This article was written in recognition of diabetes awareness month – November 2009.
For additional information about this initiative, please contact firstname.lastname@example.org.
Visit the website of the NMA Diabetes Education Program!
From Dr. Daniel Laroche