Defeudis Giuseppe, Mazzilli Rossella, Scandurra Cristiano, Di Tommaso Alfonso Maria, Cimadomo Danilo, Strollo Rocky, Faggiano Antongiulio, Migliaccio Silvia, Napoli Nicola
Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy.
Department of Movement, Human and Health Sciences, University Foro Italico of Roma, Rome, Italy.
Diabetes Metab Res Rev. 2023 Jul;39(5):e3629. doi: 10.1002/dmrr.3629. Epub 2023 Mar 3.
The aim of this study was to evaluate the relationships between health literacy, unrealistic optimism, and adherence to glycometabolic disease management related to erectile dysfunction (ED) in male patients with type 2 diabetes (T2D) or preDM.
This prospective observational study enroled 167 consecutive patients with T2D and ED. All patients underwent the following examinations: (a) medical history collection; (b) Body Mass Index (BMI) determination; (c) hormonal and biochemical assessment; (d) duration of T2D, complications and treatment; (e) International Index of Erectile Function-5 questionnaire to assess ED; and (f) validated questionnaire to evaluate health literacy, unrealistic optimism, and treatment adherence.
Overall, mean age was 62.5 ± 9.4 years (range: 20-75) and mean BMI was 28.4 ± 4.8 kg/m (range: 18.4-46.6). The mean IIEF-5 score was 15.4 ± 5.2 (range: 5-25). The majority of patients showed high health literacy. However, low health literacy was found in patients with higher IIEF-5 scores and high BMI. Unrealistic optimism was low in most patients. Higher adherence to treatment was found in patients who reported regular physical activity, who followed a diet, and in patients with a family history of T2D. Regarding anti-diabetic treatment, patients treated with insulin showed higher health literacy than patients not treated with other medications, whereas higher adherence was found in patients using SGLT2-i.
This study highlighted the close relationship between metabolic compensation, BMI, ED, and psychological attitudes, including health literacy and unrealistic optimism.
本研究旨在评估2型糖尿病（T2D）或糖尿病前期男性患者的健康素养、不切实际的乐观态度与勃起功能障碍（ED）相关的糖代谢疾病管理依从性之间的关系。
这项前瞻性观察性研究连续纳入了167例T2D和ED患者。所有患者均接受了以下检查：（a）病史采集；（b）体重指数（BMI）测定；（c）激素和生化评估；（d）T2D病程、并发症及治疗情况；（e）国际勃起功能指数-5问卷评估ED；（f）经过验证的问卷评估健康素养、不切实际的乐观态度和治疗依从性。
总体而言，平均年龄为62.5±9.4岁（范围：20-75岁），平均BMI为28.4±4.8kg/m（范围：18.4-46.6）。国际勃起功能指数-5平均得分为15.4±5.2（范围：5-25）。大多数患者表现出较高的健康素养。然而，国际勃起功能指数-5得分较高和BMI较高的患者健康素养较低。大多数患者不切实际的乐观态度较低。报告经常进行体育锻炼、遵循饮食的患者以及有T2D家族史的患者治疗依从性较高。关于抗糖尿病治疗，使用胰岛素治疗的患者比未使用其他药物治疗的患者健康素养更高，而使用钠-葡萄糖协同转运蛋白2抑制剂（SGLT2-i）的患者依从性更高。
本研究强调了代谢代偿、BMI、ED与心理态度（包括健康素养和不切实际的乐观态度）之间的密切关系。
