Androgen Pattern in Patients With Type 2 Diabetes-associated Erectile Dysfunction: Impact of Metabolic Control REPLY

OBJECTIVES To assess the impact of diabetes mellitus (DM) control on androgen pattern in men with type 2 DM-associated erectile dysfunction (ED). METHODS This is a prospective office-based study. A total of 159 ED male patients with DM were enrolled in this study. Erectile function was assessed using the international index of erectile function IIEF Diabetes control was instituted using lifestyle modification in addition to hypoglycemic agents and/or insulin therapy. Regular follow-up visits were scheduled every 4 weeks to adjust the anti-DM treatment according to patients' response and tolerance. At baseline, 3- and 6-month visits, patients were assessed for control of DM, ED severity, and total testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), and insulin assessment. RESULTS Of all patients, 25.8%, 6.3%, and 30.2% had low total T, low DHEA-S, and hyperinsulinemia, respectively, at baseline visit. There were significant increases in the mean total T levels (4.2 +/- 1.9 vs 4.7 +/- 2.1 and 5.3 +/- 2.2) and significant decreases in insulin level (23.7 +/- 17.4 vs 22.8 +/- 15.3 and 17.8 +/- 13.9) at 3- and 6-month visits, respectively. There were significant associations between good control of DM or decreased fasting blood sugar and normal levels of total T at 3- and 6-month visits. The prevalence of patients with normal testosterone and severe ED was significantly increased at 3- and 6-month visits. CONCLUSIONS The present study clearly demonstrated that there were significant associations between control of DM and normal total T levels at 3- and 6-month follow-up visits. UROLOGY 74: 552-560, 2009. (C) 2009 Elsevier Inc.