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

Sexual dysfunction is so highly prevalent in elderly males that it is often considered an inevitable consequence of "normal aging." To determine if other factors are related to an age-associated decline in sexual function, we surveyed two groups of elderly male veterans in a geriatric ambulatory care clinic: aged 65 to 75 years ("young-old") and aged over 75 ("old-old"). We compared their survey responses with responses from a general medical clinic for unstable medical patients, aged under 65 ("old-young"). Of 347 subjects surveyed, 225 completed a health and sexual function questionnaire (response rate = 65%). Absent libido was reported by 30% of old-young, 31% of young-old, and 47% of old-old. Erectile dysfunction was reported in 26% of old-young, 27% of young-old, and 50% of old-old (P less than .01). We used ordinal logistic regression and found overall sexual dysfunction to be significantly related to subjective poor health, diabetes mellitus, and incontinence (P less than .05), while controlling for age. These data suggest that, although sexual dysfunction is more common in the aged, it is often related more to comorbid illness than aging alone.
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PMID:The role of aging and chronic disease in sexual dysfunction. 337 32

Diabetes mellitus and hypertension are both prevalent in the adult population. The development of hypertension in the diabetic patient is likely to increase the morbidity and mortality in a subgroup already at high risk for atherosclerosis and deserves special consideration. Several studies have confirmed the beneficial effects of antihypertensive therapy on complications such as diabetic nephropathy. This emphasizes the importance of normalizing blood pressure in the diabetic population. It has been suggested that the threshold for initiating antihypertensive therapy should be lower in diabetic patients. All antihypertensive agents have potential disadvantages in patients with diabetes. The commonly encountered effects include deterioration of diabetic control, sexual dysfunction, electrolyte imbalance, and lipid disorders. The adverse effects of these agents on serum lipids have been implicated in the less-than-expected reduction in coronary heart disease noted in some studies. The recent Lipid Research Council study has emphasized the importance of elevated lipid levels and increased cardiovascular mortality. Antihypertensive therapy has advanced rapidly in the last 5 yr. The special problems in the treatment of hypertension within the diabetic population are now receiving greater attention. Undesirable biochemical side effects of drugs used to treat hypertension have become publicized, and the long-term consequences of these abnormalities are under critical scrutiny. The new antihypertensive medications offer exciting alternative approaches to the more traditional agents with less chance of significant metabolic side effects.
Diabetes Care
PMID:Current therapeutic concepts in diabetic hypertension. 352 14

Studies in the streptozotocin rat model for diabetes mellitus suggest that sexual dysfunction in these animals may result from diabetes-induced alterations of the neuroendocrine-reproductive tract axis. Our investigation was performed to better define the effects of diabetes on the neuroendocrine sex accessory organ axis in the male rat. Rats were rendered diabetic, and were either left untreated or treated with insulin, testosterone or both. Diabetes resulted in decreased body and reproductive organ weights, as well as diminished sperm counts and motility and prostatic acid phosphatase. Seminal fructose was increased. A significant decrease in serum LH, FSH and testosterone was noted. Insulin treatment of the diabetic rats restored serum gonadotropins, reproductive organ weight, sperm counts and motility, and seminal fructose to control levels. Prostatic weight and prostatic acid phosphatase levels remained abnormal. Testosterone restored the above mentioned parameters to control levels, with the exception of LH. Treatment with insulin and testosterone had a synergistic effect on spermatogenesis. A GnRH stimulation test demonstrated that pituitaries of diabetic animals had a blunted response, with diminished LH and FSH secretion. In the diabetic animal, there are both pituitary and testicular abnormalities which may be responsible for reproductive dysfunction.
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PMID:The effect of streptozotocin-induced diabetes on the neuroendocrine-male reproductive tract axis of the adult rat. 359 11

Emotional considerations are crucial to the management of diabetes. These include the impact of diabetes on the patients' everyday life, and the impact of day-to-day stress. The role which the patient adopts - "healthy" or "sick" - is only partially related to the actual medical status. In this study we have focused on some of the long-standing emotional reactions related to diabetes, e. g. somatopsychological reactions. These reactions are common and some, such as reduced bodily self-esteem, sexual dysfunction and use of the disease as an alibi, are more common in men. The diabetics feel that some of these reactions are more common in themselves than in their partners. The symptoms correlate with acceptance of the disease. The risk of sexual dysfunction appears to be lower in the well-adjusted patient despite the possible presence of organic complications. In the management of diabetes these somatopsychological reactions must be treated in order to achieve the best possible medical status and an acceptable way of life for the individual and his/her family.
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PMID:Emotional aspects in a chronic disease: a study of 101 insulin treated diabetics. 373 15

This study examined prospectively the prevalence and type of sexual dysfunction in a well-characterized group of 160 insulin-treated (Type 1) diabetics during a 6-year period. Of the original sample, 101(76%) participated in the follow-up study and were considered representative of the original consecutive sample. In this study each patient was his/her own control. Prevalence and type of sexual dysfunction was similar to reports from the first investigation and similar to prevalences from other studies. At both examinations a significantly higher prevalence of sexual dysfunction was recorded among diabetic men with signs of peripheral neuropathy. A group of diabetic patients had recovered from their sexual problems in the intervening period without any therapeutic procedures and without any changes in their diabetic status. Psychosocial events seemed to be major factors. Recovery was seen even in patients having peripheral and/or autonomic neuropathy. Although a significant correlation of peripheral neuropathy and erectile dysfunction in diabetic men was demonstrated, many patients with peripheral and/or autonomic neuropathy were without any sexual concerns. Reported sexual dysfunction was significantly correlated to clinical assessment of disease-acceptance and prevalence of somatopsychological reactions to the disease. Of importance in optimal diabetes therapy and in sexual dysfunction research in diabetics is the integration of emotional and behavioral aspects without forsaking the somatic factors. In routine diabetes control sexual aspects should be incorporated in the overall counseling of the diabetic patient or the diabetic couple.
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PMID:Sexual dysfunction in insulin-treated diabetics: a six-year follow-up study of 101 patients. 374 Oct 87

This study examined sexual dysfunction in diabetic women. Eighty-one insulin-treated diabetic women were interviewed and administered standardized questionnaires. Using criteria derived from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III; American Psychiatric Association, Washington, D.C., 1980), 38 (47%) of the women were diagnosed with sexual dysfunction and 43 (53%) did not report sexual problems. The more frequently reported sexual problems were inhibited sexual excitement, inhibited sexual desire, and dyspareunia. Diabetic women with sexual dysfunction were more depressed, more stereotyped in their sex-role definitions, and less satisfied in their sexual relationships than those without sexual dysfunction. The two groups did not differ in metabolic control, insulin dose, duration of diabetes, or frequency of diabetic complications (e.g., neuropathy, etc.). Results suggest that diabetes may be associated with inhibited sexual excitement and dyspareunia in women. Both psychological and physiological concomitants of sexual dysfunction in diabetic women should be considered in diagnostic and treatment programs.
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PMID:Sexual dysfunction in diabetic women. 374 98

Sexual dysfunction was studied in 50 patients who had had a myocardial infarction (MI) matched with 50 control patients who were comparable in terms of age, hypertension, diabetes, and smoking. The MI group revealed sexual dysfunction in 76%, with erectile dysfunction in 42%. In the control group there was sexual dysfunction in 68% and erectile dysfunction in 48%. There was no statistically significant difference observed between the two groups. However, there was a significant influence of sex counseling on subsequent sexual functioning. Patients who received information as to when it was safe for them to resume sexual activity showed a lesser degree of apprehension in the post-MI period. The need of sexual rehabilitation for these patients and more thorough epidemiological comparative studies are suggested.
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PMID:Myocardial infarction and its influence on male sexual function. 380 Jun 40

The presence of sexual dysfunction was studied comparatively in 80 insulin treated diabetic women, 26-45 years of age, and in an age-matched control group of women without chronic somatic disease or psychiatric illness. We found no significant difference in the incidence of sexual dysfunction between the two groups (27.5% and 25% respectively). In diabetics and controls, the most common symptom of sexual dysfunction was reduced libido (22.5% in both groups) while only 18% complained of orgasmic dysfunction. In diabetics, sexual dysfunction was not correlated to age and diabetes duration. Sexual dysfunction was correlated to peripheral neuropathy but not to retinopathy, nephropathy, reduced beat-to-beat variation, regulation quality, insulin treatment and age at diabetes onset. Nearly half the patients reporting sexual dysfunction were without any late diabetic complications, indicating the influence of psychosocial factors. Somatopsychic reactions (emotional reactions to somatic disease) seem to be of relevance, although diabetic women may have less problems in this area than diabetic men. A better acceptance of the disease might partly explain the difference in sexual complications between diabetic males and females. Diabetic women and their partners should be offered, at least once a year, the possibility to discuss interpersonal relationships and the emotional aspects of living with diabetes. Most sexual problems should be handled in the diabetes clinic and only selected cases referred for sex therapy.
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PMID:Sexual dysfunction in younger insulin-treated diabetic females. A comparative study. 407 8

This study assessed the quality of the sexual relationship in 51 couples that included a Type I diabetic partner (23 male and 28 female). Using traditional diagnostic criteria, the frequencies of sexual dysfunction was higher in diabetic than in healthy men, as in previous studies. Diagnosis based on a multiaxial system showed that both male and female diabetics had more arousal phase dysfunctions than did healthy spouses. Diabetics and healthy spouses were similar in terms of sexual initiative and discrepancies between sexual desire and activity levels. Although peripheral neuropathy was correlated with sexual dysfunction in diabetic men, a stronger predictive factor was a rating of the couple's acceptance of the diabetes. Nevertheless sexual dysfunction was blamed on the diabetes by 22 of 23 couples who had a sexual problem.
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PMID:Sexual relationships in couples with a diabetic partner. 407 9

For women whose health cannot support pregnancy, the author's obstetrics department has formed a multidisciplinary team to counsel couples on psychological and practical aspects of contraception and abortion. High risk pregnancies are those occuring in women with such disorders as cardiopathy, nephropathy, hypertension, diabetes, cancer, Rhesus isoimmunization and psychosis. Two approaches are used: to prevent or terminate pregnancy. Contraception must be explained concretely, addressing the couples' particular situation and personality. Pills are often contraindicated, in high risk patients as are IUDs in nulliparas and those taking anticoagulants. Many couples used to careful medical surveillance can adjust to temperature rhythm or diaphragms. For women who must have Tubal ligation, the decision is made jointly by the couple, obstetrician, psychotherapist and specialist. Counseling is usually necessary to prevent psychological or sexual dysfunction, particularly in those sterilized during caesarean section if the infant's survival is also at risk. A similar multidisciplinary team is consulted for therapeutic abortion alone or combined with tubal ligation.
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PMID:[Fecundity and high risk pregnancy]. 507 55


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