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

Impotence in diabetic men is usually considered to be due to neuropathic factors or vascular insufficiency. However, factors unrelated to diabetes may occasionally produce sexual dysfunction in these patients. Recently, a diabetic patient presented to our clinic with the complaint of impotence. In this patient, macroprolactinemia was discovered. With appropriate therapy, the sexual dysfunction improved and this case is reported here.
Diabetes Care
PMID:Impotence as a presenting symptom of presumed prolactinoma in a patient with diabetes mellitus. 633 47

We evaluated 70 patients for male sexual dysfunction in our center during its first 6 months of operation. The results of the analysis demonstrated that 55 per cent had organic impairment. Several important findings should be emphasized. There was mild elevation of serum prolactin in 6 cases, none of which was the direct cause of the impotence. A total of 15 patients had a diagnosis of either impaired glucose tolerance or overt diabetes (7 with organic and 8 with psychogenic disease). Therefore, the diagnosis of diabetes or impaired glucose tolerance, whether known previously or not, should not be accepted as confirming the organicity of impotence. Also, nocturnal penile tumescence alone confirmed the diagnosis of psychogenic impotence only when a rigid erection 5 minutes in duration occurred. The absence of nocturnal erections cannot be interpreted as conclusive evidence of organic impotence. Finally, a definitive diagnosis of psychogenic impotence was made based only on visual sexual stimulation in 6 patients. Our results emphasize further that etiologic factors of organic or psychogenic impotence are complex and that a multidisciplinary approach should be used.
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PMID:Evaluation of the first 70 patients in the center for male sexual dysfunction of Beth Israel Medical Center. 669 Jul 47

Hypertension occurs 2 to 3 times more frequently in diabetic persons than in nondiabetic persons. Care must be taken in treating hypertension in diabetic patients because the choice of antihypertensive agent may worsen the diabetic state or its complications or cause additional health problems for the patient. Sexual dysfunction is a common problem in diabetic patients; however, diabetes need not be the cause. Diabetic men with hypertension have an increased sensitivity to the side effect of sexual dysfunction, which occurs from the use of centrally acting antihypertensive agents. By using prazosin, an alpha 1-adrenergic blocking agent, this cause of sexual dysfunction was eliminated. The reasons for the increased prevalence of hypertension in diabetic patients are discussed and a rational approach is given for the treatment of elevated blood pressure in these individuals.
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PMID:Treatment of hypertension in diabetic men: problems with sexual dysfunction. 669 65

In a previous publication, we presented evidence of slowed conduction speed in the central nervous systems of insulin-dependent diabetic subjects, manifest in a delay in the latency of the brainstem auditory-evoked response (BAER). In this article, we present the results of a multivariate study conducted on a larger sample of 50 insulin-dependent, adult diabetic subjects. The purpose of the study was to determine some of the functional correlates of the BAER delay; each patient received an assessment of the BAER, the late auditory-evoked potential (EP), the conduction velocities of the sural, median, and common peroneal nerves, and intellectual and emotional function, in addition to neurologic and audiologic examinations. A nondiabetic control group was matched with the diabetic group as to age and sex. The results indicated a delay in the latency of wave V, and in interpeak latencies I-III and I-V, of the BAER. The most reliable effect was on interpeak latency I-V; this suggested that the locus of the delay was in the central auditory projections, rather than in the acoustic nerve. In addition, BAER waves I, II, III, IV, and V were reduced in amplitude, as was the N1 component of the late auditory EP; the most reliable reduction in amplitude was in wave V. The effect was similar in magnitude for males and females, relative to their counterparts in the control group. The slowed BAER response appeared early in the disease and was not related to the duration of insulin treatment. It was correlated with a chronic loss of energy and the presence of sexual dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1984 Jul
PMID:Functional correlates of reduced central conduction velocity in diabetic subjects. 673 44

We studied 20 men (ages 46 to 69, mean 45 years) with chronic obstructive pulmonary disease (FEV1 of 0.55 to 2.1 L), to determine the relative importance of pulmonary impairment vs other occult physical or psychologic factors in the genesis of sexual dysfunction. Seven subjects had ceased sexual activity concomitant with worsening of their pulmonary symptoms; six because of erectile impotence and one due to dyspnea. Frequency of intercourse for the remaining 13 was 16 percent of prelung disease levels, and libido was decreased to 25 percent of premorbid levels. Nocturnal penile tumescence monitoring disclosed that six subjects had organogenic erectile impotence (OEI). None of the subjects showed signs of peripheral vascular disease as assessed by Doppler examination of peripheral pulses (including penile). The mean bulbocavernosus reflex latency (BCRL) for the OEI group (N = 5) was 40.2 msec, while that for the group with full nocturnal erections (N = 10) was 34.5 msec (P less than 0.005). Four subjects had occult diabetes mellitus evident on oral glucose tolerance tests, and one had evidence of an androgen deficit. The correlation coefficient for rank by sexual dysfunction vs pulmonary impairment and age was 0.66 (P less than 0.005) and 0.24 P greater than 0.05), respectively. Subjects with OEI tended to have the worst pulmonary function test results and the highest T-scores on the hypochondriasis, depression, and hysteria scales of the Minnesota Multiphasic Personality Inventory. Data suggest that sexual dysfunction worsens as lung disease worsens and that chronic obstructive pulmonary disease may be associated with male impotence in the absence of other commonly known causes.
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PMID:Sexual dysfunction and erectile impotence in chronic obstructive pulmonary disease. 680 73

We evaluated 31 male diabetics for sexual dysfunction. Patients were examined by an endocrinologist, psychologist or psychiatrist, urologist and neurophysiologist. Evaluation was done by penile blood pressure, pudendal nerve latency, psychologic testing and laboratory tests, including serum testosterone levels. Mean patient age was 53 years and the average onset of sexual dysfunction was 6 years after the diagnosis of diabetes. Results showed that 68 per cent of the patients had evidence of vascular occlusion, 26 per cent had neurologic abnormalities, 19 per cent had low plasma testosterone levels and 38 per cent had relevant psychological problems, although the condition was considered primarily psychogenic in only 19 per cent. Of those patients with abnormal nerve latencies 86 per cent had abnormal Doppler penile systolic pressures, while only 28 per cent of the patients with abnormal penile pressures had abnormal neurologic findings. These data suggest that vascular occlusion is the most prevalent abnormality in impotent diabetics and may predate neurologic abnormalities. The diabetics were divided into 2 groups, insulin-dependent and insulin-nondependent patients. A higher incidence of vascular lesions was found in insulin-dependent diabetics (83 versus 57 per cent), suggesting that vascular pathological conditions are related to severity of the diabetes. Although most diabetics have a vascular etiology for impotence one must remember that other causes may be present and that a thorough investigation is necessary.
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PMID:Etiology of diabetic impotence. 683 92

Although sexual dysfunction in the male diabetic has been recognized for many years, only recently has systematic investigation been undertaken to understand the problems involved. The marked increase of impotence in diabetes has been shown to be, to a significant extent, a result of diabetic autonomic pelvic neuropathy. However, awareness of other causes of impotence is essential for proper diagnosis and appropriate therapy. Strikingly, the marked impact of diabetes on male sexual function is not shared by the female diabetic patient, whose sex interest and orgasmic reaction are essentially unimpaired when compared with those of the nondiabetic female.
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PMID:Sexual function in diabetic patients. 735 25

In this review, we examine the changes in sexual function that accompany deviations from "normal" physiological states. We propose that the changes one observes in many altered physiological states should not be viewed in isolation. We describe our paradigms for assessing sexual function, and proceed to evaluate how sexual function changes with hormonal deprivation and aging, in rat models for hypertension, in severe hyperprolactinemia, in streptozotocin-induced diabetes, after chronic alcohol intake, after chronic morphine administration, and after exposure to the heavy metal, cadmium. We will provide evidence for the involvement of adrenergic transmitters and two neuropeptides, neuropeptide Y and somatostatin, in the neuroendocrine regulation of sexual behavior. Finally, we compare and contrast the changes observed relative to the changes seen in "normal" aging in rats. The sequence of age-related changes in sexual function is distinct. The first change observed is a decrement in ex copula erectile reflexes. Next are decreases in ejaculatory threshold, followed shortly by increases in initiation and reinitiation of copulation after ejaculation. This is followed by a decrement in the number of males copulating to ejaculation. Finally, there is a failure to initiate the copulatory process. This sequelae is relatively common, being evident after castration, with hyperprolactinemia, and after exposure to cadmium. The data available for sexual function in hypertension is incomplete and modified by the etiology, but a suggestion for this sequelae is seen in SHR. In contrast, sexual dysfunction associated with chronic morphine administration appears to be due to an initial deficit in motivational aspects. Testosterone reverses sexual dysfunction associated with castration, but not with idiopathic sexual inactivity, nor with sexual dysfunction associated with aging, diabetes, or chronic morphine administration. Comparing sexual function in rat models for hypertension, diabetes and chronic ethanol leads to the conclusion that increases in blood pressure, like decreases in testosterone, cannot be the primary causal factor for sexual dysfunction. Age, hormonal history of the subject, and the age at castration influence changes in sexual function. Age-related sexual dysfunction appears to be contributed to by changes in adrenergic-neuropeptidergic, to include sympathetic, systems. Site-specific administration of NPY induces alterations in parameters of copulatory behavior which mimic those seen in aging and the retention of ejaculatory behavior with aging is associated with site-selective attenuation (or reversal) of age-associated changes in NPY content. Yohimbine enhances copulatory activity in castrated and aging rats, and attenuates or reverses the antisexual effects of clonidine, epinephrine and somatostatin.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sexual function in altered physiological states: comparison of effects of hypertension, diabetes, hyperprolactinemia, and others to "normal" aging in male rats. 763 May 83

The aim of the study was to assess psychological contributors or correlates of sexual dysfunction in diabetic men. The study was conducted on 40 diabetic men and 40 age-matched healthy volunteers. The subjects underwent a psychosexual interview with their sexual partners and had a comprehensive medical evaluation to rule out the confounding effects of other illnesses or medications. Psychiatric, psychological and marital information was obtained with the Schedule for Affective Disorders and Schizophrenia (SADS-L), the SCL-90-R, the Derogatis Sexual Function Inventory, the Locke-Wallace Marital Adjustment test and the Dyadic Adjustment Inventory. Compared to controls, diabetic patients had significantly lower levels of erotic drive, sexual arousal, enjoyment and satisfaction. Problems in these areas coexisted with alterations in sexual attitudes and body image but were not related to group differences in marital adjustment as reported separately by the patients and their partners. There was no evidence that psychological distress or psychiatric disorders are associated with diabetes or with its effects on sexual function.
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PMID:Diabetes, psychological function and male sexuality. 763 74

Patients referring to the Urology and/or Endocrinology Departments of Ankara Medical School with complaints of diabetes mellitus (DM) and related complications were evaluated during the last year. A detailed history was obtained and all of the patients were questioned especially about sexual function problems. Following this evaluation, all patients were divided into two main groups, i.e. patients with sexual disorders, and those with normal sexual function. Factors such as BPH, cerebrosclerosis and other important vascular-neurologic pathologies which may play a role in the etiology of impotence were excluded from the study and 38 patients with sexual dysfunction and 15 with normal sexual activities have undergone further evaluation. Following routine blood and urine analyses, serum hormone levels (testosterone, FSH, LH, prolactin) were determined. Penile color-flow doppler analysis, cavernosometry, cavernosography, bulbocavernous reflex latency time and evaluation of somatosensory evoked potentials were performed. Additionally, all patients were evaluated from the psychiatric aspect using the Hamilton depression scale and MMPI questionnaire. The presence of vascular or neurologic pathology in 89.4% of our patients and of both pathologies in 39.4% of the patients, indicated the importance of multifactorial evaluation of diabetic impotence in order to plan a complete and efficient therapy program.
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PMID:Multidisciplinary evaluation of diabetic impotence. 771 29


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