PURPOSE: We determined whether intensive glycemic therapy reduces the risk of erectile dysfunction in men with type 1 diabetes enrolled in the Diabetes Control and Complications Trial. MATERIALS AND METHODS: The Diabetes Control and Complications Trial randomized 761 men with type 1 diabetes to intensive or conventional glycemic therapy at 28 sites between 1983 and 1989, of whom 366 had diabetes for 1 to 5 years and no microvascular complications (primary prevention cohort), and 395 had diabetes for 1 to 15 years with nonproliferative retinopathy or microalbuminuria (secondary intervention cohort). Subjects were treated until 1993, and followed in the Epidemiology of Diabetes Interventions and Complications study. In 2003 we conducted an ancillary study using a validated assessment of erectile dysfunction in 571 men (80% participation rate), 291 in the primary cohort and 280 in the secondary cohort. RESULTS: Of the participants 23% reported erectile dysfunction. The prevalence was significantly lower in the intensive vs conventional treatment group in the secondary cohort (12.8% vs 30.8%, p = 0.001) but not in the primary cohort (17% vs 20.3%, p = 0.49). The risk of erectile dysfunction in primary and secondary cohorts was directly associated with mean HbA1c during the Diabetes Control and Complications Trial, and Epidemiology of Diabetes Interventions and Complications combined. Age, peripheral neuropathy and lower urinary tract symptoms were other risk factors. CONCLUSIONS: A period of intensive therapy significantly reduced the prevalence of erectile dysfunction 10 years later among those men in the secondary intervention cohort but not in the primary prevention cohort. Higher HbA1c was significantly associated with risk in both cohorts. These findings provide further support for early implementation of intensive insulin therapy in young men with type 1 diabetes.
RCT Entities:
PURPOSE: We determined whether intensive glycemic therapy reduces the risk of erectile dysfunction in men with type 1 diabetes enrolled in the Diabetes Control and Complications Trial. MATERIALS AND METHODS: The Diabetes Control and Complications Trial randomized 761 men with type 1 diabetes to intensive or conventional glycemic therapy at 28 sites between 1983 and 1989, of whom 366 had diabetes for 1 to 5 years and no microvascular complications (primary prevention cohort), and 395 had diabetes for 1 to 15 years with nonproliferative retinopathy or microalbuminuria (secondary intervention cohort). Subjects were treated until 1993, and followed in the Epidemiology of Diabetes Interventions and Complications study. In 2003 we conducted an ancillary study using a validated assessment of erectile dysfunction in 571 men (80% participation rate), 291 in the primary cohort and 280 in the secondary cohort. RESULTS: Of the participants 23% reported erectile dysfunction. The prevalence was significantly lower in the intensive vs conventional treatment group in the secondary cohort (12.8% vs 30.8%, p = 0.001) but not in the primary cohort (17% vs 20.3%, p = 0.49). The risk of erectile dysfunction in primary and secondary cohorts was directly associated with mean HbA1c during the Diabetes Control and Complications Trial, and Epidemiology of Diabetes Interventions and Complications combined. Age, peripheral neuropathy and lower urinary tract symptoms were other risk factors. CONCLUSIONS: A period of intensive therapy significantly reduced the prevalence of erectile dysfunction 10 years later among those men in the secondary intervention cohort but not in the primary prevention cohort. Higher HbA1c was significantly associated with risk in both cohorts. These findings provide further support for early implementation of intensive insulin therapy in young men with type 1 diabetes.
Authors: Jeanette S Brown; Hunter Wessells; Michael B Chancellor; Stuart S Howards; Walter E Stamm; Ann E Stapleton; William D Steers; Stephen K Van Den Eeden; Kevin T McVary Journal: Diabetes Care Date: 2005-01 Impact factor: 19.112
Authors: David M Nathan; Patricia A Cleary; Jye-Yu C Backlund; Saul M Genuth; John M Lachin; Trevor J Orchard; Philip Raskin; Bernard Zinman Journal: N Engl J Med Date: 2005-12-22 Impact factor: 91.245
Authors: A D Seftel; N D Vaziri; Z Ni; K Razmjouei; J Fogarty; N Hampel; J Polak; R Z Wang; K Ferguson; C Block; C Haas Journal: Urology Date: 1997-12 Impact factor: 2.649
Authors: James M Hotaling; Aruna V Sarma; Darshan P Patel; Barbara H Braffett; Patricia A Cleary; Eva Feldman; William H Herman; Catherine L Martin; Alan M Jacobson; Hunter Wessells; Rodica Pop-Busui Journal: Diabetes Care Date: 2016-06-28 Impact factor: 19.112
Authors: Aruna V Sarma; James M Hotaling; Ian H de Boer; Rodney L Dunn; Mary K Oerline; Karandeep Singh; Jack Goldberg; Alan Jacobson; Barbara Braffett; William H Herman; Rodica Pop-Busui; Hunter Wessells Journal: J Hypertens Date: 2019-05 Impact factor: 4.844
Authors: Rodica Pop-Busui; Jim Hotaling; Barbara H Braffett; Patricia A Cleary; Rodney L Dunn; Catherine L Martin; Alan M Jacobson; Hunter Wessells; Aruna V Sarma Journal: J Urol Date: 2015-01-10 Impact factor: 7.450
Authors: Melody R Palmer; Sarah K Holt; Aruna V Sarma; Rodney L Dunn; James M Hotaling; Patricia A Cleary; Barbara H Braffett; Catherine Martin; William H Herman; Alan M Jacobson; Hunter Wessells Journal: J Sex Med Date: 2017-08-26 Impact factor: 3.802
Authors: James M Hotaling; Daryl R Waggott; Jack Goldberg; Gail Jarvik; Andrew D Paterson; Patricia A Cleary; John Lachin; Aruna Sarma; Hunter Wessells Journal: J Urol Date: 2012-06-15 Impact factor: 7.450
Authors: S Furukawa; T Sakai; T Niiya; H Miyaoka; T Miyake; S Yamamoto; K Maruyama; T Ueda; H Senba; Y Todo; M Torisu; H Minami; M Onji; T Tanigawa; B Matsuura; Y Hiasa; Y Miyake Journal: Int J Impot Res Date: 2016-10-27 Impact factor: 2.896
Authors: M I Maiorino; G Bellastella; E Della Volpe; O Casciano; L Scappaticcio; P Cirillo; D Giugliano; K Esposito Journal: Int J Impot Res Date: 2016-09-22 Impact factor: 2.896
Authors: Istvan Kovanecz; Dolores Vernet; Maryam Masouminia; Robert Gelfand; Leila Loni; James Aboagye; James Tsao; Jacob Rajfer; Nestor F Gonzalez-Cadavid Journal: J Sex Med Date: 2016-05 Impact factor: 3.802