20 Years of Diabetes Research Provides Interesting Insights for the Risk of ED and LUTS: Insights from the 27th SMSNA Annual Meeting
On Friday, October 9, at the 27th Annual SMSNA Fall Scientific Meeting, Dr. Aruna Sarma discussed sexual dysfunction and lower urinary tract symptoms (LUTS) in diabetes, specifically the opportunities and information that can be gathered from UroEDIC. She explained that erectile dysfunction (ED) is one of the leading complications of diabetes, and that glycemia and autonomic neuropathy drive the onset of diabetes-related dysfunction.
Forty years of large diabetes studies have provided some of the richest databases on diabetes. Dr. Sarma says her team has been leveraging existing data to identify urologic complications. Early control of glycemic exposure can positively impact ED and urinary tract infections (UTIs). Despite differences in ED trajectories, autonomic neuropathy appeared to be the biggest predictor of ED in men with diabetes. Type 1 diabetes, specifically, is considered a "clean" model. People with type 1 diabetes may be studied without other comorbidities, such as obesity, and may now be experiencing some of the urologic complications as adults. Dr. Sarma says the key is knowing what questions to ask and how to find the answers.
An interesting part of her research, she says, is that LUTS and ED do not always coexist. LUTS and ED can affect a person independently or together. For 75% of her study population, ED tended to come first. She states that once LUTS develops, it is difficult to eliminate. However, when treating both ED and LUTS, LUTS may improve while ED does not. In women, depression accounts for about half of the association between LUTS and female sexual dysfunction (FSD). A major part of their FSD assessment included pain, which can contribute to depression and further LUTS.
Dr. Sarma concluded with several key takeaways:
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ED is one of the leading complications of diabetes.
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LUTS can wax and wane, so treat symptoms and reassess the patient.
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Glycemia and autonomic neuropathy drive the onset of diabetes-related dysfunction.
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Routine check-ups should include questions about sexual function.
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Researchers should combine data sources and large, deeply characterized cohorts to expand the scale of their research.
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