Sun P et al. (2006) Erectile dysfunction—an observable marker of diabetes mellitus? A large national epidemiological study. J Urol 176: 1081–1085
Erectile dysfunction and diabetes mellitus share a number of risk factors, and often coexist. As erectile dysfunction is more evident to patients than diabetes mellitus, it has been suggested that erectile dysfunction could be used as an early indicator of diabetes mellitus.
Sun and colleagues conducted a retrospective study into the prevalence of diabetes mellitus in men aged ≥18 years, with (n = 285,436) and without (n = 1,584,230) erectile dysfunction. Patient data were obtained from a large, US, managed-care claims database. The authors found that the prevalence of diabetes mellitus was almost three times higher in men with erectile dysfunction than in men without erectile dysfunction (20.0% versus 7.5%, respectively). After adjustment for age, geographical region and concurrent diseases, this association between diabetes mellitus and erectile dysfunction remained significant (P <0.0001).
Compared with men without erectile dysfunction, men with erectile dysfunction had an overall odds ratio of 1.60 for diabetes mellitus. Age had a nonlinear effect that might limit the usefulness of erectile dysfunction as a marker for diabetes mellitus in older men, however: the peak odds ratio of 2.94 occurred in men aged 26–35 years, whereas men aged ≥66 years had an odds ratio approaching 1.
These data confirm that men with erectile dysfunction are more likely to have diabetes mellitus than men without erectile dysfunction. The authors suggest that erectile dysfunction could be a useful early marker of diabetes mellitus in men aged ≤45 years, but this marker is not useful in men aged ≥66 years.