Peculiarities of correction of sexual function in men presenting with diabetes mellitus

Diabetes mellitus (DM) is frequently associated with disturbances of the sexual function underlain by hypogonadism and neuropathy. These pathologicalconditions are successfully managed by androgens, alpha-lipoic acid, and phosphodiesterase type 5 inhibitors, besides compensation of carbohydratemetabolism. This paper reports results of evaluation of different methods for the treatment of erectile dysfunction in DM patients basedat Endocrinological Research Centre. Their combination ensured higher than 90% efficiency of therapy

Hormonal and metabolic characteristic of androgen deficiency and its correction by testosterone in men with type 1 diabetes mellitusundergoing programmed hemodialysis

Aim. To study the prevalence of androgen deficiency in men with type 1 diabetes mellitus (DM1) undergoing programmed hemodialysis (PHD) andto develop methods for the treatment of metabolic disorders. Materials and methods. The study included 43 men with DM1 on PHD. Group 1 comprised 20 patients below 40 years of age, group 2 included23 older patients. Patients of group 1 were allocated to subgroup A (treated with testosterone and ether mixture (TEM)); and control subgroup B(n=14 and 6 respectively). Patients of group 2 were divided into subgroup C (treated with TEM) and control subgroup D (n=14 and 9 respectively).Patients in the study and control subgroups were matched for age, duration of DM1, hemodialysis (years), total testosterone (TT, nmol/l), hemoglobin(Hb, g/l) and glycated hemoglobin (HbA1c, %) levels. All the patients were treated with epoetin-beta (EPO-b) on an individual basis depending onHb level; TEM was given thrice weekly. Results. Group 1: age 34.0?3.9 yr, HbA1c 9.3?1.4%, Hb 118.1?9.6 g/l, TT 21.2?6.6 nmol/l. Group 1: age 47.3?3.5 yr, HbA1c 9.5?1.8%,Hb 94.9?5.7 g/l, TT 9.8?3.9 nmol/l. Androgen deficiency was diagnosed in 48.8% (total group), 5.0% (group 1) and 86.9% (group 2) of the patients.Reduction of TT level was not accompanied by a significant rise in LH concentration to above normal values (p>0.05). HbA1c level in eithergroup did not significantly change within 6 months after the onset of the study. Combined treatment with EPO-b and TEM resulted in a Hb concentrationof 118.2?6.7 g/l in subgroup A (p=0.79). Hb level in subgroup C increased to 113.5?6.3 g/l (p=0.009). Hb changes in control groups wereinsignificant. Requirement for EPO-b in subgroups A and C decreased by 32.1% (p=0.007) and 41.1% (p=0.001) respectively but remained unalteredin both control subgroups. Conclusion. Reduction of the TT level in men with DM1 on PHD is a function of age and constitutes an independent risk factor of anemia. Androgendeficiency and its correction have no effect on carbohydrate metabolism. Combined treatment with EPO-b and TEM increases blood Hb level in oldermen and reduces requirement for EPO-b regardless of the age

Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM). Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients