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 the relative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ± 7.9 years). The prevalence of erectile dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectile dysfunction 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 at increased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I²  = 67%, k = 8). Erectile dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with erectile dysfunction is warranted.