High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies

Erectile dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess therelative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 forstudies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis ofthe prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthycontrols, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initialhits, 145 studies were included representing 88 577 men (age: 55.8 ? 7.9 years). The prevalence of erectile dysfunctionin diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectiledysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction< 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI,0.008 to 0.040; P = 0.003; R2= 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were atincreased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I2= 67%, k = 8). Erectiledysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds ofapproximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for menwith erectile dysfunction is warranted