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Query: UMLS:C0011849 (diabetes)
277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of sexual dysfunction and the pituitary-gonadal function were studied in 72 consecutive diabetic male patients. Sexual dysfunction was found in 43% and in these patients peripheral neuropathy was significantly more frequent than in patients with normal sexual function. Sexual dysfunction was more frequent in patients at the age of 50--55 years than in young diabetics (age 25--30 years). No significant correlation between sexual dysfunction and the duration of the disease and no difference in the serum concentrations of luteinizing hormone, follicle stimulating hormone, prolactin, testosterone and oestradiol-17beta between patients with normal and reduced sexual function was found. It is concluded, that sexual dysfunction is not accompanied by altered serum concentrations of testosterone, oestradiol 17beta, gonadotrophins or prolactin. Sexual dysfunction correlates with peripheral neuropathy, but the high prevalence of dysfunction in males with short duration of diabetes without neuropathy makes other causes likely.
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PMID:Sexual function and pituitary axis in insulin treated diabetic men. 28 15

Erectile dysfunction is the most prevalent sexual dysfunction in neurogenically disabled men. Studies of rehabilitation patients indicate that the restoration of sexual functioning is considered an important priority. This article reports on a pilot study of vacuum tumescence constriction therapy as a noninvasive method for use by a population with traumatic or nontraumatic neurologic disorders such as spinal cord injury, stroke, multiple sclerosis, and diabetes mellitus. Of the 30 patients who participated in the study, 17 purchased the device and over 50% of them reported using the device on a long-term basis. Frequency of coitus increased from 0.3/wk to 1.5/wk. Included in the study are methods used by patients to integrate the device into their sex life, the role of the patient's partner in the decision to purchase the device, and the rate of partner satisfaction. There were no reports of substantial morbidity. Thus, this method shows promise as a noninvasive treatment for men who are moderately to severely neurogenically disabled.
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PMID:Noninvasive treatment for erectile dysfunction in the neurogenically disabled population. 140 45

As sexual dysfunction is a well-recognized manifestation of diabetes mellitus and as the function of the prostate, a major accessory organ in the male reproductive system, is regulated by the autonomic nervous system, we studied beta adrenergic receptors in the prostate of streptozotocin-induced diabetic rats, using radioligand receptor binding techniques. Four groups of rats were maintained for 8 weeks: controls, diabetics, insulin-treated diabetics, and myoinisitol-treated diabetics. The diabetic and myoinisitol-treated diabetic animals were smaller, had higher blood glucose levels, higher water intake and urine output, smaller prostates, and lower serum insulin levels than the other groups. Saturation experiments with [3H]dihydroalprenolol showed that the induction of diabetes decreased the density of beta adrenergic receptors in prostatic membrane particulates. Inhibition studies with selective beta adrenergic antagonists demonstrated that these receptors were of the beta 2 subtype. Furthermore, insulin but not myoinositol treatment normalized blood glucose and insulin levels, maintained normal prostate and body weight-gain, and prevented the decrease in the density, i.e., down-regulation, of the prostatic beta adrenergic receptors.
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PMID:Beta adrenergic receptor alterations in diabetic rat prostate: effects of insulin and dietary myoinositol. 168 23

Nocturnal penile tumescence (NPT) studies are commonly used in the assessment of sexual dysfunction in diabetic men. While much of the evidence in favor of its use has come from the observation of markedly abnormal NPT in impotent diabetic men, little research has focused on the quality of nocturnal erections in sexually functional diabetics. Ten diabetic men who reported normal daytime sexual function were studied with 4 nights of polysomnography, including NPT assessment. They had significantly diminished NPT profiles when compared with that of an age-matched, nondiabetic, healthy control group. Without controlling for the effect of diabetes on NPT, between 70% and 90% of sexually functional diabetics had NPT profiles in a range that would be classified as indicative of organic sexual dysfunction for a man presenting for evaluation of sexual dysfunction. The finding of NPT abnormalities in a diabetic man should not be taken as evidence for irreversible sexual dysfunction. Rather, the condition of diabetes appears to result in NPT abnormalities, regardless of the adequacy of daytime sexual function.
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PMID:Results of nocturnal penile tumescence studies are abnormal in sexually functional diabetic men. 172 6

The functional state of the hypophyseal-gonadal system was investigated in 160 males suffering from Types I and II diabetes mellitus. There were no correlations revealed in the incidence and severity of sexual dysfunction according to the patients' ages, diabetes type and duration. The sexual disturbances correlated with the severity of diabetic microangiopathy (r = +0.48) and a state of diabetic compensation (r = +0.36). The development and progression of diabetic nephropathy was accompanied by a rise of blood luteinizing and follicle-stimulating hormones and a drop of testosterone, estrogen-androgen imbalance.
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PMID:[The effect of diabetic nephropathy on the function of the hypophyseal-gonadal system in men]. 185 9

Considerable evidence suggests that hyperactivity of the sympathetic nervous system is implicated not only in the pathogenesis of essential hypertension but also in several blood pressure-independent complications of essential hypertension. Even with the advent of newer antihypertensive agents, including angiotensin-converting enzyme inhibitors and calcium antagonists, the centrally acting sympatholytics (alpha 2-adrenoceptor agonists) remain a valuable group of medications for the management of hypertension of all grades of severity. Their advantages include efficacy; rarity of contraindication; absence of most metabolic and serious side effects; favorable effects on systemic hemodynamics; lack of true tolerance and infrequency of volume expansion-related pseudotolerance; suitability in the elderly, in isolated systolic hypertension, and in patients with various concomitant conditions, such as diabetes mellitus; ability to reverse left ventricular hypertrophy; and relative low cost. The long duration of action of guanfacine hydrochloride, the most recently marketed agent, and of the transdermal formulation of clonidine is an especially commendable feature. The principal disadvantages of this class of medications are an overlap between the therapeutic dosage and that producing sedation and dry mouth and the potential to cause the discontinuation syndrome and sexual dysfunction.
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PMID:Use of centrally acting sympatholytic agents in the management of hypertension. 187 68

Patients with type II diabetes mellitus were assessed for symptoms of depression using the Zung Self-Rated Depression Scale (Zung SDS) and the Beck Depression Inventory (BDI). The patients were classified according to the presence or absence of diabetic complications, and they were compared with a group of demographically matched, nonmedically ill control subjects. The patients with diabetic complications scored significantly higher on the depression inventories than did the patients without complications and the control subjects. Factor analysis of BDI responses revealed that cognitive symptoms of depression were prominent in the diabetic patients with complications. In this group, 74% of patients scored within the range of clinical depression on the BDI; 35% scored within the range of severe depression. Symptoms of sexual dysfunction were significantly correlated with symptoms of depression in diabetic women but not in diabetic men. The findings are discussed within the context of other research in the behavioral aspects of diabetes mellitus.
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PMID:Symptoms of depression in patients with type II diabetes mellitus. 188 19

These data, in combination with the literature reviewed above, demonstrate several important points for those who work in clinics where elders with sexual problems are seen: 1. The currently available literature on the relation of sexual dysfunction to psychiatric disorder in the elderly is not extensive, and much of the literature is limited by methodologic flaws. There is a clear need for improved research methods and a broader data base. Nonetheless, the existing studies indicate that psychologic disorders are found in conjunction with sexual dysfunction commonly enough that clinicians must regularly assess for their presence. 2. The cause of sexual problems is seldom simple or entirely clear. Diagnoses of psychologic concerns and disorders that might relate to sexual dysfunction are common, and most older patients' sexual dysfunction will have a mixed cause, with both medical and psychologic factors playing an important role in the development and maintenance of sexual dysfunction. In our series of patients, 52.8% had diagnosable psychologic difficulties that were assumed to be related to the sexual difficulties. Another large group (39.9%) had psychologic factors (although not diagnosable disorders) that were assumed to contribute to the current manifestation of sexual dysfunction. Thus, it should not be assumed, as it was in years past, that when one likely causative factor is identified (e.g, diabetes, performance anxiety, or depression), the cause of the dysfunction has been identified. 3. The types of psychopathology seen in sex clinics are typically fairly limited, with the largest proportions by far being alcohol abuse or depression (50.1% and 62.1%, respectively, of all psychologic diagnoses in our clinic). Major psychopathology is relatively underrepresented. We suspect this underrepresentation does not reflect a true population characteristic but, rather, a selection difference; patients with major psychopathology such as schizophrenia either do not complain of sexual dysfunction to their therapists or are not referred for treatment by their therapists. 4. The presenting complaints of patients with a psychologic disorder do not differ significantly from those of patients without a psychologic disorder in a general sexual dysfunction clinic. 5. Treatment outcome, especially the rate of successful treatment, does not differ between those with and those without psychologic diagnoses when physicians and psychologists work together on an interdisciplinary team to offer treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Psychologic disorder and sexual dysfunction in elders. 200 86

Clinical data from 37 adult males with diabetes mellitus (insulin dependent, n = 22; non-insulin dependent, n = 15) who had undergone psychiatric diagnosis and peripheral nerve conduction studies were reviewed to determine whether psychiatric illness was significantly related to complaints of sexual dysfunction. Main-effects testing revealed that impotence was associated with both neuropathy (P less than 0.01) and psychiatric illness (P less than 0.001). Logistic regression analysis was then used to determine the independent relationships of these two variables with impotence. After controlling for the effects of neuropathy, psychiatric illness (generalized anxiety disorder and depression) remained significantly associated with sexual dysfunction (P less than 0.01). These data allow for the hypothesis that psychiatric illness may be an important contributor to impotence in diabetic men, as it is in nondiabetic men, even when neuropathic complications of the disease are present.
Diabetes Care 1990 Aug
PMID:Relationship of psychiatric illness to impotence in men with diabetes. 220 27

Hypertension and diabetes mellitus are chronic medical conditions that frequently coexist. In the United States, it is estimated that 10 million persons suffer from diabetes mellitus, 60 million from hypertension, and 3 million from the combination of the two. There may be a causal relationship between hypertension and diabetes. Obesity may be a precipitating factor for both hypertension and non-insulin-dependent diabetes mellitus. Those with insulin-dependent diabetes mellitus generally become hypertensive only with the onset of nephropathy. Glucose tolerance, insulin resistance, and hyperinsulinemia frequently occur with essential hypertension and may be aggravated by hypertension therapy, especially with diuretics and beta-blockers. Hyperinsulinemia may be an important common factor promoting sodium retention, sympathetic nervous system stimulation, and inhibition of the sodium pump. The Working Group on Hypertension in Diabetes has outlined a flexible modified version of the stepped-care approach to the treatment of hypertension in diabetes. Management is complex because diabetes is associated with autonomic neuropathy, sexual dysfunction, hyperlipidemia, and fluid and electrolyte disorders. All these problems can be exacerbated by antihypertensive treatment. Nonpharmacologic measures, which address weight reduction and sodium restriction, are logical, but aggressive antihypertensive medication is invariably necessary. Diuretics and/or beta-blockers were the mainstay of treatment until the introduction of angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers. These newer agents have no deleterious effects on carbohydrate metabolism and are generally better tolerated. Antihypertensive therapy may slow the rate of deterioration in diabetic nephropathy. This was first shown with diuretics, beta-blockers, and hydralazine and more recently with ACE inhibitors, which provide effective blood pressure control and a significant drop in albuminuria without affecting the glomerular filtration rate adversely. ACE inhibition may also lead to increased insulin sensitivity and glucose disposal rate. Long-term trials are needed to assess the effects of these new agents on the treatment of hypertension in the diabetic population.
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PMID:Diabetes mellitus and hypertension. 222 Jul 97


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