Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka.
Ontology highlight
ABSTRACT: Objective
Prevalence of erectile dysfunction (ED) in diabetic men is considerably high but it is often underdiagnosed and undermanaged. There were no data available about the prevalence and the risk factors of ED in our region. So a cross-sectional study was conducted to identify the prevalence and associated risk factors of ED in a tertiary care diabetic center in Northern Sri Lanka.Results
326 diabetic male patients between ages 18-60 years were interviewed. Majority (62.9%; 95% CI 57.5-68.0%) of the diabetic patients suffered from ED and 22.4% (95% CI 17.8-26.8%) were found to have severe ED. Most of the patients (98.8%) were not screened or treated for ED. Bivariate analysis showed age above 40, duration of DM (>?5 years), type of diabetes (type 2), having micro-vascular complications, co-existing hypertension, BMI, consuming unsafe level of alcohol and taking beta-blockers were associated with ED at 5% level (P??40 (AOR: 2.13; 95% CI 1.05-4.33), duration of diabetes (AOR: 2.90; 95% CI 1.67-5.01), co-existing hypertension (AOR: 1.8; 95% CI 1.06-3.06), and unsafe level alcohol intake (AOR: 3.14; 95% CI 1.76-5.59) were independent risk factors.
SUBMITTER: Nisahan B
PROVIDER: S-EPMC6451292 | biostudies-literature | 2019 Apr
REPOSITORIES: biostudies-literature
Publications
Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka.
Nisahan Balasingam B Kumanan Thirunavukarasu T Rajeshkannan Nadarajah N Peranantharajah Thampipillai T Aravinthan Mahalingam M
BMC research notes 20190405 1
<h4>Objective</h4>Prevalence of erectile dysfunction (ED) in diabetic men is considerably high but it is often underdiagnosed and undermanaged. There were no data available about the prevalence and the risk factors of ED in our region. So a cross-sectional study was conducted to identify the prevalence and associated risk factors of ED in a tertiary care diabetic center in Northern Sri Lanka.<h4>Results</h4>326 diabetic male patients between ages 18-60 years were interviewed. Majority (62.9%; 95 ...[more]
Similar Datasets
Project description:BackgroundDiabetic retinopathy (DR) is one of the leading causes for complete loss of vision among working-aged adults around the world. The present study aims to evaluate the rate of DR and its risk factors among the adults with young-onset diabetes from a tertiary care setting in Sri Lanka.MethodsA consecutive sample of 1,007 individuals referred from multiple centers, were invited for the study. Ophthalmological evaluation was done, with dilated indirect ophthalmoscopy by an Ophthalmologist. Retinopathy was classified according to the International Clinical DR Disease Severity Scale. An interviewer-administered questionnaire was used to collect socio-demographic and anthropometric details. Seated blood pressure, Fasting Blood Glucose (FBG), HbA1c and urine microalbumin were also measured. Data were analysed using SPSSv14. A binary logistic regression analysis was performed in all patients, with 'presence of DR' as the dichotomous dependent variable and other independent covariates.ResultsSample size was 684 (response rate-67.9%), mean age was 37.1?±?5.9 years and 36.0% were males. Mean duration of diabetes was 5.2?±?4.0 years. Previous retinal screening had been done in 51.0% by a non-specialist doctor and in 41.5% by a consultant ophthalmologist. Rate of any degree of DR in the study population was 18.1% (Males 16.4%, Females 20.0%; P?=?NS). In patients with DR, majority had mild Non-Proliferative DR (NPDR) (57.2%), while 32.2% had moderate NPDR, 0.8% had severe NPDR and 9.7% had maculopathy. Mean age, duration of diabetes, systolic (SBP) and diastolic blood pressure (DBP), FBG, HbA1c and urine microalbumin levels were significantly higher amongst the patients with DR. The results of the binary logistic regression indicate that the duration of diabetes (OR:1.24), HbA1c (OR:1.19), age (OR:1.11), urine Microalbumin (OR:1.11) and DBP (OR:1.04) all were significantly associated with DR.ConclusionsIn this large multi center study, nearly one in five adults with young-onset diabetes was found to have retinopathy. Age, duration of diabetes, HbA1C and urine Microalbumin levels were significantly associated with the presence of retinopathy, while HbA1c was also a significant factor determining severity. Nearly 50% of the study population has never undergone retinal screening by an ophthalmologist, highlighting the need for well organized screening programs.
| S-EPMC3943575 | biostudies-literature
Project description:End TB strategy by the WHO suggest active screening of high-risk populations for tuberculosis (TB) to improve case detection. Present study generates evidence for the effectiveness of screening patients with diabetes mellitus (DM) for Pulmonary TB (PTB). A study was conducted among 4548 systematically recruited patients over 45 years attending DM clinic at the National Hospital of Sri Lanka. The study units followed an algorithm specifying TB symptom and risk factor screening for all, followed by investigations and clinical assessments for those indicated. Bacteriologically confirmed or clinically diagnosed PTB were presented as proportions with 95% CI. Mean (SD) age was 62·5 (29·1) years. Among patients who completed all indicated steps of algorithm, 3500 (76·9%) were investigated and 127 (2·8%) underwent clinical assessment. Proportion of bacteriologically confirmed PTB patients was 0·1% (n = 6,95%CI = 0·0-0·3%). None were detected clinically. Analysis revealed PTB detection rates among males aged ≥60 years with HbA1c ≥ 8 to be 0·4% (n = 2, 95%CI = 0·0-1·4%). The study concludes that active screening for PTB among all DM patients at clinic settings in Sri Lanka, to be non-effective measure to enhance TB case finding. However, the sub-category of diabetic males with uncontrolled diabetics who are over 60 years of age is recommended as an option to consider for active screening for PTB.
| S-EPMC8031956 | biostudies-literature
Project description:BackgroundSeveral studies have shown that erectile dysfunction (ED) influences the risk of cardiovascular events (CV events). However, a meta-analysis of the overall risk of CV events associated with ED in patients with diabetes has not been performed.Methodology/principal findingsWe searched MEDLINE and the Cochrane Library for pertinent articles (including references) published between 1951 and April 22, 2012. English language reports of original observational cohort studies and cross-sectional studies were included. Pooled effect estimates were obtained by random effects meta-analysis. A total of 3,791 CV events were reported in 3 cohort studies and 9 cross-sectional studies (covering 22,586 subjects). Across the cohort studies, the overall odds ratio (OR) of diabetic men with ED versus those without ED was 1.74 (95% confidence interval [CI]: 1.34-2.27; P<0.001) for CV events and 1.72 (95% CI: 1.5-1.98; P<0.001) for coronary heart disease (CHD). The funnel plot, Begg's test, and Egger's test did not show evidence of publication bias (all P>0.05). Moreover, meta-regression analysis found no relationship between the method used to assess ED (questionnaire or interview), mean age, mean hemoglobin A(1c), mean body mass index, or mean duration of diabetes and the risk of CV events or CHD. In the cross-sectional studies, the OR of diabetic men with ED versus those without ED was 3.39 (95% CI: 2.58-4.44; P<0.001) for CV events (N = 9), 3.43 (95% CI: 2.46-4.77; P<0.001) for CHD (N = 7), and 2.63 (95% CI: 1.41-4.91; P = 0.002) for peripheral vascular disease (N = 5).Conclusion/significanceED was associated with an increased risk of CV events in diabetic patients. Prevention and early detection of cardiovascular disease are important in the management of diabetes, especially in view of the rapid increase in its prevalence.
| S-EPMC3433443 | biostudies-literature
Project description:BackgroundMale sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic.MethodsA cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler ultrasonography was performed on consenting participants with erectile dysfunction. Associations were assessed using the chi-square test or Fisher's exact for dichotomous variables and independent sample t-test for continuous variables.ResultsTwo hundred and twelve participants were recruited with a mean age of 54.1 (SD = 10.1) years. Erectile dysfunction was present in 168 (79.2%), (mild: 45, mild-moderate: 56, moderate: 26, severe: 41). Premature ejaculation was present in 26 (18.7%). Libido was low among 16%. Sexual dysfunction was not revealed to a health provider by 85.6% despite 60.5% experiencing psychological and/or relationship effects. Out of 18 who sought treatment, only 4 achieved a good response. Mean age (55.4 ± 9.5 vs 48.7 ± 10.6 years, p < 0.001) and duration of diabetes (10.9 ± 7.6 vs 5.8 ± 4.6 years, p < 0.001) were higher while eGFR was lower (73.9 ± 27.7 vs 100.51 ± 28.08 years, p < 0.008) among those with ED compared to those without. Diabetic retinopathy (4% vs 42%, p < 0.001), peripheral neuropathy (17.9% vs 38.4%, p = 0.041) and lower limb arterial disease (0% vs 12.2%, p = 0.04) were associated with ED. Arterial insufficiency was seen among 50% of the participants who underwent penile colour Doppler ultrasonography.ConclusionsMale sexual dysfunction is a pervasive yet underappreciated problem in diabetes care despite its effect on the individual. Patient and disease characteristics would guide the identification of high-risk individuals for targeted screening in clinical practice.
| S-EPMC9382620 | biostudies-literature
Project description:BackgroundOne in five adults in Sri Lanka has either diabetes or prediabetes, and one-third of those with diabetes are undiagnosed. Diabetic foot is a debilitating condition affecting up to 50% of patients with both type 1 and type 2 diabetes. The risk of nontraumatic lower limb amputations is 15 times higher in diabetic patients when compared with nondiabetics. Patient education about correct foot care practices is the cornerstone of prevention of diabetic foot disease.ObjectiveTo assess the prevalence of diabetic foot disease, knowledge, and practices about diabetic foot care among diabetic patients.Methods334 patients attending the diabetic clinic in Colombo South Teaching Hospital were recruited according to the inclusion and exclusion criteria. Data were collected using 3 questionnaires, and they were filled using the foot examination findings, patients' medical records, and direct interviewing of the patients.ResultsThe mean age of the patients included in the study was 58.23 ± 10.65 years while the median duration of diabetes was 10.54 ± 7.32 years. 34.1% patients had peripheral neuropathy, and 29.5% had peripheral vascular disease. Diabetic foot disease according to the WHO definition was present only in 23 (6.9%) patients. There was a significant association between peripheral neuropathy and current or past foot ulcer which took more than 2 weeks to heal (p < 0.05). Knowledge about foot care was less among the studied population, and it was associated with poor foot care practices. Presence of diabetic foot and current or past foot ulcer which took more than 2 weeks to heal were significantly associated with the foot care knowledge and practices (p < 0.05).ConclusionImprovement of patients' knowledge about foot care and their practices have a significant impact on the reduction of diabetic foot disease.
| S-EPMC7714566 | biostudies-literature
Project description:Background: This study aimed to obtain an overview of survivors of gender-based violence GBV who seek care, different types and consequences of (GBV), their modes of referral, factors associated with GBV, characteristics of the perpetrators, health-seeking behavior of the care-seekers and the service provided by GBV Care Centers in two tertiary care settings Methods: A retrospective cross-sectional study was conducted from January 2017 to December 2019 at two GBV care centers in a Women's Hospital and a General Hospital in Colombo, Sri Lanka. Sociodemographic details of care-seekers, referral methods, types of violence experienced and their consequences, factors associated with GBV, characteristics of the perpetrator, health seeking behavior of those seeking care, and the services provided, were obtained from the hospital records. Results: Records from all care seekers (n=495 women, no men) were obtained, and 488 were suitable for analysis. More women presented with GBV to the Women's Hospital compared to the General Hospital (395 vs 93, p<0.001), and there were significant differences in modes of referral between the two hospitals. A large majority had suffered emotional and economic violence, although physical or sexual violence were the reasons for referral to the centers. Suicidal tendencies had been reported by 20%. In 94.2% of cases the husband, lover or partner was the perpetrator. Physical violence was more likely in married women, those who did not report a stable relationship, and in those who were employed. Of the 488 women, 37% were pregnant at the time of violence. Most of the women had confided with another female about the violence. Less than 5% came for follow-up. Conclusions: GBV care services should be offered in all hospitals, especially those providing maternity and gynaecological care. Emotional and economic violence are common but often overlooked. There is a need to increase public awareness about GBV.
| S-EPMC7199284 | biostudies-literature
Project description:BackgroundMen with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate.MethodsMen ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches), and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF) were administered.ResultsOf 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053), of whom 54% (399/744) had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range) number of risk factors was 2.9 ± 1.7 (3-8) in the "yes" group, 3.2 ± 1.7 (3-9) in the "unsure" group, and 2.6 ± 1.5 (2-8) in the "no" group.ConclusionAlthough awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction.Trial registrationClinicalTrials.gov Identifier NCT00343200.
| S-EPMC2991280 | biostudies-literature
Project description:BackgroundNutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school children. This study was undertaken to identify the prevalence of wasting, stunting and obesity among school children from Northern Sri Lanka and associated socio-demographic factors.MethodsA community based cross-sectional study was carried out using multistage stratified proportionate cluster among healthy children attending schools in the Northern part of the country. Height and weight were measured, and Body Mass Index (BMI) calculated [weight (kg)/Height (m) 2]. BMI-for-age z-score (BAZ) and Height for age Z (HAZ) scores were determined and WHO growth references were used to categorise the nutritional status. Correlation between various nutritional problems with Maternal education, household income, number of family members and the residential area was assessed.ResultsA total of 1012 children were recruited, and the mean age and standard deviation were 11.12±1.77 yrs. Girls in the age ranges of 9-14 were heavier and taller when compared to the boys compatible with the pubertal growth spurt. Stunting based on the height for age was seen in 10.9% of boys and 11.8% of girls. Wasting based on BMI for age WHO standard (WHO 2007) was seen in 30.6% of boys and 29.1% of the girls. The prevalence of overweight was 11% and Obesity was 6.3% of the population. Obesity was predominantly seen in boys (4.2%) and it was significantly higher when compared to the girls (2.1%) (p < 0.001). Obesity in older boys (> 10 years) was significantly more than the younger ones (p < 0.01). Maternal education and family income had a significant impact on the prevalence of wasting, stunting and obesity whereas the family size contributed to the wasting and obesity (p< 0.001).ConclusionFindings suggest that stunting, wasting, overweight and obesity are prevalent among 6-16-year-old leading to concerns in public health. The nutritional status significantly varies according to the geographical location, maternal education and the household income.
| S-EPMC7814636 | biostudies-literature
Project description:Protein expression profiles in rat corporal smooth muscle tissue were compared between animal models of streptozotocin-induced diabetes mellitus (STZ-DM) and age-matched controls (AMCs) at 1 week and 2 months after induction of hyperglycemia with STZ treatment. At each time point, protein samples from four STZ-DM and four AMC rat corpora tissues were prepared independently and analyzed together across multiple quantitative two-dimensional gels using a pooled internal standard sample to quantify expression changes with statistical confidence. A total of 170 spots were differential expressed among the four experimental groups. A subsequent mass spectrometry analysis of the 170 spots identified a total of 57 unique proteins. Network analysis of these proteins using MetaCore suggested altered activity of transcriptional factors that are of too low abundance to be detected by the two-dimensional gel method. The proteins that were down-regulated with diabetes include isoforms of collagen that are precursors to fibril-forming collagen type 1; Hsp47, which assists and mediates the proper folding of procollagen; and several proteins whose abundance is controlled by sex hormones (e.g. CRP1 and A2U). On the other hand, proteins seen or predicted to be up-regulated include proteins involved in cell apoptosis (e.g. p53, 14-3-3-gamma, Serpinf1, Cct4, Cct5, and Sepina3n), proteins that neutralize the biological activity of nerve growth factor (e.g. anti-NGF 30), and proteins involved in lipid metabolism (e.g. apoA-I and apoA-IV). Subsequent Western blot validation analysis of p53, 14-3-3-gamma, and Hsp47 confirmed increased p53 and 14-3-3-gamma and decreased Hsp47 levels in separate samples. According to the results from the Western blot analysis, Hsp47 protein showed a approximately 3-fold decrease at 1 week and was virtually undetectable at 2 months in diabetic versus control. Taken together, our results identify novel candidate proteins playing a role in erectile dysfunction in diabetes resulting from STZ treatment.
| S-EPMC2849705 | biostudies-literature