PREVALENCE, INCIDENCE AND RISK FACTORS OF ERECTILE DYSFUNCTION IN MALES WITH TYPE 1 DIABETES ENROLLED IN THE PITTSBURGH EPIDEMIOLOGY OF DIABETES COMPLICATIONS STUDY (EDC) (1986-2007)

Objective: To: 1)determine the prevalence and incidence of ED in males with T1D enrolled in the Pittsburgh Epidemiology of Diabetes Complication (EDC) study from 1986 to 2007; 2)identify risk factors for development of ED; 3)identify the development of ED in relation to other markers of neuropathy; and, 4) determine behavioral and cognitive risk factors associated with the development of ED. Design: The EDC was a cohort study of 333 males with T1D: mean age of 27.53years (SD±7.8, range 8.5-47.4); 331 Caucasians and 2 African Americans; and, duration of diabetes of 19.6years (SD±7.5, range 7.7-37.4). Age-specific ED prevalence was determined from baseline (1986-1988) while age-specific incidence was determined from longitudinal data (1988-2007). Results: Prevalence rate was 10.4 %. Thirty-one had ED: mean age of 35.8years (SD±5.3, range 22.9-44.8) and mean duration of diabetes 26.9years (SD±5.9, range 8.1-37.4). Males with prevalent ED did not statistically differ from males without ED in metabolic control (HbA1), education, income, or the current use of ACE or lipid lowering medications. Associated risk factors for the 31 prevalent cases included; CDSP, HDL and BDI score. Incidence rate was 17.78 % (n=54) from 1989-2007 with a mean age of 40.61years (SD±5.9, range 26.7-60.8) and mean duration of diabetes of 32.54years (SD±5.88, range 20.9-51-9). Mean HbA1 was 10.68% (SD±2.19). Associated risk factors for the 54 incident cases included; CDSP, nonHDL cholesterol, and BDI score. E/I Ratio was significant (p<.01) at the time of the event, but not in the preceding event cycle (p=.18). CDSP was significant (p<.01) in the preceding cycle to ED development and at the time of event (p<.01). For the repeated measure analysis, CDSP was significant in the preceding cycle to the ED development but not at the time of the event. The following differences were found between those with and without ED: knowledge of diabetes (p=.04); self-management (p=.10); and, perception of severity (p=.08). However no significant difference was found between the two groups for self-efficacy. CONCLUSION: CDSP, HDL, nonHDL and total BDI score were risk factors for development of ED in males with T1D. Therefore, these should be assessed for frequently in males with T1D

Long-Term Effects of the Booster-Enhanced READY-Girls Preconception Counseling Program on Intentions and Behaviors for Family Planning in Teens With Diabetes

OBJECTIVE: To examine 12-month effects of a booster-enhanced preconception counseling (PC) program (READY-Girls) on family planning for teen girls with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: Participants 13–19 years of age (n = 109) were randomized to a standard care control group (CG) or intervention group (IG) that received PC over three consecutive clinic visits. Prepost data were collected at baseline, 3- and 6-month booster sessions, and a 12-month follow-up visit. RESULTS: Mean age was 15.8 years; 9 (8%) subjects had type 2 diabetes; and 18 (17%) subjects were African American. At baseline, 20% (n = 22 of 109) had been sexually active, and of these, 50% (n = 11) had at least one episode of unprotected sex. Over time, IG participants retained greater PC knowledge (F[6, 541] = 4.05, P = 0.0005) and stronger intentions regarding PC (significant group-by-time effects) especially after boosters. IG participants had greater intentions to discuss PC (F[6, 82.4] = 2.56, P = 0.0254) and BC (F[6, 534] = 3.40, P = 0.0027) with health care providers (HCPs) and seek PC when planning a pregnancy (F[6, 534] = 2.58, P = 0.0180). Although not significant, IG participants, compared with CG, showed a consistent trend toward lower rates of overall sexual activity over time: less sexual debut (35 vs. 41%) and higher rates of abstinence (44 vs. 32%). No pregnancies were reported in either group throughout the study. CONCLUSIONS: READY-Girls appeared to have long-term sustaining effects on PC knowledge, beliefs, and intentions to initiate discussion with HCPs that could improve reproductive health behaviors and outcomes. Strong boosters and providing PC at each clinic visit could play important roles in sustaining long-term effects