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New research published in Endocrine revealed findings that may contribute to preventing erectile dysfunction in men with type 2 diabetes.

New research published in Endocrine revealed a correlation between blood glucose fluctuation indicators and erectile dysfunction (ED), with low time in range (TIR) levels emerging as an independent risk factor for ED in men with type 2 diabetes mellitus.

“This study contributes to the prevention and treatment of ED in men with type 2 diabetes, thereby improving patients’ QOL and family happiness,” explained Shenhang Yao, MD, and colleagues.

The cross-sectional study included 317 men with type 2 diabetes who were categorized into non-ED (n=76) and ED (n=241) groups based on the International Index of Erectile Function-5 (IIEF-5) scores. Patients were further segmented into four groups based on TIR quartiles. Demographic and laboratory data were collected, and glucose fluctuation indicators were assessed via flash glucose monitoring.

Compared with the non-ED group, patients in the ED group were significantly older (54 vs 46 years) and had longer diabetes duration (7 vs 4 years), and higher HbA1C (8.60 vs 8.20). The researchers noted that this suggests ED is an important complication in the disease, significantly affected by diabetes control. In addition, the differences in the occurrence of cerebral infarction and diabetic peripheral neuropathy between the two groups were statistically significant (P<0.05).

Analysis of TIR quartiles demonstrated statistically significant differences in various laboratory tests among the four groups (P<0.05), with a higher frequency of diabetic peripheral vascular disease in the group with lower TIR (P<0.05). The prevalence of ED decreased as TIR increased (94.94%, 79.75%, 74.68%, 55.00%, respectively).

The ED group showed significantly lower TIR and IIEF-5 scores than the non-ED group (P<0.05). An increase in TIR levels correlated with higher IIEF-5 scores and a considerable decrease in ED incidence (P<0.05).

There was also a positive correlation between IIEF-5 scores and TIR (r=0.48; P<0.01), and multivariate logistic analysis confirmed that low TIR is an independent risk for ED (P<0.05), after adjusting for confounding factors.

The study was subject to several limitations, including its single-center, cross-sectional design. The IIEF-5 is widely used but relies on self-reported data, which could have introduced bias to the results. Lastly, the researchers adjusted for confounding variables but did not include factors like psychological status and antihyperglycemic drugs.

Nevertheless, the researchers recommended steps that clinicians can take to lower the risk for ED in this patient population.

“Personalized blood glucose-lowering strategies should be developed, focusing not only on achieving HbA1C targets but also on stable blood glucose control, especially the TIR indicator, to reduce the frequency and duration of hyperglycemia and hypoglycemia, and to maintain patients’ blood glucose within the ideal target range,” the researchers concluded.