Database of diseases - Diabetes

  Many people are aware of the dangers of diabetes-related complications. However, only some people know that erectile dysfunction is among these complications.  
DIABETES AND ERECTRIC DISEASES
CAUSES OF DIABETES EREQUENCES IN DIABETES
MEDICINES AGAINST DISEASE DISORDERS

DIABETES AND ERECTRIC DISEASES   . Erectile dysfunction is a persistent inability to achieve or maintain an erection sufficient to conduct a satisfying sexual intercourse.
Erectile dysfunction is a significant medical problem and belongs to the chronic complications of diabetes, significantly reducing the quality of life of the patient. At the same time, this problem is considered "embarrassing" not only by patients, but also by doctors. . Do you really have diabetes and erectile dysfunction? Yes. Diabetes is considered a strong risk factor for erectile dysfunction. Erectile dysfunction associated with diabetes, especially type 1 diabetes, often affects young people. It is estimated that up to 50% of patients with diabetes have erection problems, and the same probability of erectile dysfunction in diabetic patients is four times higher than in healthy patients. .
Can Erectile Dysfunction Indicate Unrecognized Diabetes? Yes. This type of disorder is most often not a disease "in itself" and is usually associated with the occurrence of other diseases, especially cardiovascular diseases, mainly associated with atherosclerosis. Atherosclerosis, even at an early stage of development, significantly impairs the function of the cavernous arteries, which leads to a decrease in the inflow of blood to the corpus cavernosum of the penis. Therefore, erectile dysfunction can be considered as an early signal of cardiovascular disease. Diabetes significantly accelerates the development of atherosclerosis and also causes neuropathy, which significantly disturbs the chain of reactions leading to erection. . What percentage of men with diabetes suffer from erectile dysfunction? It is estimated that erectile dysfunction affects between 28 and 59% of diabetic patients, with the risk of erectile dysfunction in patients with diabetes increasing with their age. The results of one study indicate that about 15% of men aged 30-34 and 56% of patients aged 60 years suffer from erectile dysfunction associated with diabetes.
  . CAUSES OF DIABETES EREQUENCES IN DIABETES . . The parasympathetic nervous system is responsible for the erection.
This system is part of the autonomic nervous system (vegetative nervous system), which is a set of fibers and ganglia - motor and sensory neurons - partly independent of the central nervous system. It is the same nervous system that regulates the digestion or work of the heart, innervates the smooth muscles of the digestive tract, the skin, lungs, kidneys, heart and blood vessels and it is interesting for us - reproductive organs and numerous hormonal glands. The functioning of the autonomic nervous system is outside the control of the upper brain centers (not subject to will) or is dependent on them in a limited way. Most visceral stimuli reach only the autonomic nervous system ganglia, in which incoming information is processed into motor stimuli. . The autonomic nervous system consists of two parts: the sympathetic nervous system and the parasympathetic nervous system.
And it is this second sympathetic system that is responsible for ejaculation. .
The most important cause of erectile dysfunction in diabetes is damage to the ganglia of neurons of the nervous system, i.e. diabetic neuropathy.
Of particular importance in erectile dysfunction is the so-called autonomic neuropathy, degenerating the autonomic nervous system, regulating the functions of internal organs.Because in diabetes, a chronic excess of sugar (glucose) in the blood degenerates neurons and weakens the rate of the stimuli leading through the nervous system. This exemption is progressive and every year the conductivity decreases by nearly 1 m / sec in type 2 diabetes. In type 1 diabetes (requiring insulin injections) - deterioration of nerve fiber activity occurs the fastest, immediately after the appearance of diabetes mellitus. Over the next 2-3 years, if diabetes is well-balanced, this process is released. Neurological disorders in diabetes are not the only cause of erectile dysfunction. .
The cause of erectile dysfunction may be other diseases caused by diabetes.
The most important causes of disorders are diseases of small blood vessels (microangiopoatia) and large vessels (macroangiopathy). They accelerate atherosclerosis and can inhibit pelvic circulation and, consequently, lead to penis ischaemia and impaired sexual function. For example, atherosclerosis of the vessels that supply blood to the corpus cavernosum - due to the accumulation of cholesterol and calcium on the inner walls of the vessels, the light and intensity of blood flow are reduced, which prevents the proper sclerosis of the corpora. This may result in a longer time needed to achieve an erection, incomplete hardening of the member, or premature erection. .
Another threat to sexual activity are endocrine diseases, some medicines.
Erectile dysfunction can cause thyroid, pituitary or adrenal diseases. In addition, taking some sedatives. Smoking and alcohol abuse increase the risk of aggravation of pathological changes and sexual dysfunction.
. Mental and anxiety disorders affect sexual function..
And as we know, the impact of blood sugar on the nervous system is strong, which can be seen, for example, in the case of deep blood hypoglycaemia (hypoglycaemia), when irrational anger, aggression, apathy and even anxiety arise. However, research shows that 90% of causes of erectile dysfunction in diabetic patients are organic causes.
However, it should be remembered that in the event of erection problems, the patient's frustration only deepens the problem, strengthens it and leads to further deterioration of the quality of life. Nevertheless, psychological causes play a major role in only 10% of erectile dysfunction cases. Organic disorders caused by diseases, accidents, etc. lead the way. Psychological disorders are the result rather than the cause of problems in the intimate life. . Erectile dysfunction leads to depression, anxiety, marital problems and divorce. In the United Kingdom, they are responsible for 20% of divorces. It is therefore irresponsible to downplay the problem. Erectile dysfunction may be the first symptom of diabetes in some cases and in others it may be the first diabetic complication! This problem can not be overlooked in patient education and the physician should first address the issue in direct conversation. Research among Polish patients shows that 81% of them expect the doctor to be the first to raise this topic. According to the European Diabetes Policy Group in 1999, the doctor should talk to the diabetic person about problems in the intimate life at least once a year. Patients are often unaware of the possibility of treating "embarrassing" ailments. Therefore, such information is very important for the patient. However, it is known that today's non-invasive pharmacological methods of treating erectile dysfunction can restore the patient's self-esteem and easily remove one of the most acute complaints about the quality of life.
Source: DEVA press materials from the conference "Men's Week of Health"
MEDICINES AGAINST DISEASE DISORDERS . What method of erectile dysfunction therapy is safe for people with diabetes? In diabetic patients, you can try all the treatments for erectile dysfunction. In this population, prostaglandin E dilatation analogs are successfully used (administered in the form of intraocular rods or direct injections into the corpus cavernosum). . The oral phosphodiesterase type 5 inhibitors (PDE 5 inhibitors) such as vardenafil, sildenafil and tadalafil have become the standard treatment for erectile dysfunction in recent years. Phosphodiesterase type 5 inhibitors are currently the first line treatment for erectile dysfunction.Currently, three drugs are used in this group: sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) .. These drugs differ slightly in chemical structure, especially tadalafil, and the period of action, whereas the mechanism of their operation is identical. Vardenafil is effective in 85% of patients at a dose of 20 mg (moderate erectile dysfunction) and in 39% of patients with profound erectile dysfunction. It is also a drug that can be successfully used in the absence of response to sildenafil. Tadalafil is effective at a dose of 20 mg in 87% of patients, sildenafil - in 83%. The studies showed different preferences for drug selection by patients: 17.4% use sildenafil, 43% - vardenafil, and 39% - tadalafil. All medicines are effective in patients with diabetes. .
Are these types of medicines effective and safe for diabetics? These types of therapeutic substances are characterized by high efficacy and high safety of use in this group, which is undoubtedly difficult to treat. Naturally, one should remember about contraindications for their use, which are also valid in patients with diabetes. Is it possible to combine the administration of insulin and vardenafil? 
In other words, are there any recommendations for the simultaneous administration of both preparations and experience in their use? . Yes, it has been found in studies that vardenafil does not affect blood glucose. The availability of insulin for cells and its pharmacological action are also unaffected. Therefore, there are no special requirements for such combination therapy. . Should taking vardenafil have an impact on changing the diabetic diet? No. This drug does not affect the absorption of nutrients contained in meals, including vitamins, micro and macro elements. However, please note that a meal rich in fat (> 50%) may slightly delay the absorption of vardenafil. .
How to control a diabetic diet?
Insulin dependent diabetes sometimes suffers from a change in nutrition alone. The diet, usually based on appropriate conversion tables, should be precisely arranged according to body weight and physical activity. Meals must be properly selected caloric, should be relatively low in carbohydrate and fat, while rich in protein. In diabetes, you should not eat easily digestible carbohydrates, such as sugar, honey, sweets, processed fruit, sweet fruits and drinks. In which types of diabetes, administration of such agents is not recommended? The inclusion of vardenafil in therapy does not increase the overall risk of diabetes (both types). The drug does not interact with oral antidiabetic medicines, as well as the majority of medicines used to treat hypertension, lipid disorders or blood coagulation disorders. . Can a diabetologist prescribe prescription erection medication to his patient in justified cases? Yes, both a diabetologist and a cardiologist, a urologist or a primary care physician can write a prescription for oral PDE 5 inhibitors. .

Note - complications of diabetes can cause irreversible damage to health. It is generally known that untreated or poorly controlled diabetes can damage the retina of the eye and cause blindness, which is caused by the so-called diabetic retinopathy. Another complication - diabetic neuropathy - can damage nerve fibers and disrupt brain function. Diabetic nephropathy causes severe kidney damage - end-stage renal failure - requiring dialysis. Equally disturbing are the statistics on circulatory and heart diseases in diabetes. Diabetes, especially type 2, promotes the development of coronary heart disease and heart attack. In patients with diabetes, coronary heart disease is a particular threat. People who suffer from not yet diagnosed with diabetes often develop a latent development of coronary heart disease. .
Source: Press release - Warsaw, June 21, 2004. Contact: Elżbieta Zawiślak Jatrejon Public Relations, tel / fax (022) 885 65 54, ... 55, 56 e-mail: [email protected]; Aleksandra Nowakowska GlaxoSmithKline Pharmaceuticals tel. (022) 576 90 01 e-mail: [email protected] . .