• Diabetes and Erectile Dysfunction

Diabetes is a chronic condition that most often causes erectile dysfunction (Akerman et al 1993 Shiavi et al 1993 Close and Ryder 1995 Bancroft and Gutierrez 1996 Dunsmuir and Holmes 1996 Hakim and Goldstein 1996, Klein et al 1996). US' studies show that 30 million men may have some kind of erection problem. When studied, it is noted that this man may also have vascular disease, diabetes, or depression which shows a complex interrelationship between these pathologies.

Diabetes is a disease that provokes an inflammatory process in the body's arteries and arterioles which must be controlled by the patient. It is frequent to have diabetic patients with circulation problems, not only in the penis but also in other arteries with major size of inferior members, kidney, etc. The penis arteries because they are lowercase, are often the most affected.

The etiology of ED in diabetic population is multifactorial and ultimately evolves endocrine problems, cardiovascular, urologist and even psychiatric problems. It is estimated 35% to 75% of men with diabetes might have dysfunction if compared with other groups. Men with diabetes develops a problem of 5 to 10 years before. The development of this problem over the years in the group of diabetics happens in a progressive way. Scholars as Feldman value that the risk of erectile dysfunction is three times bigger in diabetics than in not diabetics. The harmful effect of mellitus diabetes in erectile function is shown by studies of abnormal nocturnal penile tumescence observed in diabetics with normal erectile function (Nofringer et al 1992).

PDE5 inhibitors drugs are less effective in diabetics than in populations of men without the disease. Diabetic patients are associated with accelerated atherosclerosis level, micro-vascular disease, neuropathy, dyslipidemia, hypertension and endothelial dysfunction.

These problems told above contribute a lot to the DE and their combination enhances the effects. In summary, the age of the patient, the duration of diabetes, inadequate glucose control as well as complications from diabetes increases the risk of diabetic patients.