Keshtkar Vahid, Zarmehrparirouy Mina, Izadi Mohammad Ali, Sharifi Mohammad Hossein
Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of).
Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
BMJ Open. 2025 Mar 17;15(3):e082327. doi: 10.1136/bmjopen-2023-082327.
This study was conducted to determine the predictors of sexual dysfunction and quality of life (QOL) in patients with type 2 diabetes (T2D). Sexual dysfunction is a long-term consequence of diabetes that is widely ignored in personal management, even though it can have an adverse effect on QOL.
This research was designed as a cross-sectional study.
12 diabetes centres and clinics in Shiraz, south of Iran.
390 male patients with T2D mellitus participated in this project. The inclusion criteria were being 30-65 years, having a history of diabetes of at least 1 year, having fasting blood sugar and glycosylated haemoglobin tests and being willing to participate in the study. Patients with medication treatment for mental disorders, a history of heart disease and renal failure were excluded.
QOL and erectile dysfunction (ED). The questionnaires were the Audit of Diabetes-Dependent QOL (ADDQOL) and the International Index of Erectile Function (IIEF-15). Data were reported using descriptive and analytical statistics methods.
The participants' mean age was 48.35±9.27 years. The average weighted impact (AWI) score of ADDQOL for the participants was -3.01, indicating the negative influence of diabetes on their QOL. The mean value of the total score of sexual dysfunction was 42.79±22.75, and the rates of mild, mild to moderate, moderate and severe ED were 19%, 17.7%, 17.2% and 24.6%, respectively. Sexual dysfunction was significantly related to age (OR=1.06; 95% CI: 1.02 to 1.09), diabetes duration (OR=1.04, 95% CI: 1.01 to 1.07), HbA1c (OR=1.45, 95% CI: 1.07 to 1.95), BMI (OR=1.10, 95% CI: 1.03 to 1.16), marital status (married: OR=2.30, 95% CI: 1.40 to 3.77), without diabetes complication (OR=0.17, 95% CI: 0.08 to 0.31) and insulin therapy (OR=2.86, 95% CI: 1.67 to 4.92). ADDQOL was significantly related to age (OR=1.049), HbA1c (OR=2.192), marital status (married: OR=2.089), educational level (high school certificate: OR=0.337, university degree: OR=0.295), diabetes complication (no complication: OR=0.372) and insulin therapy (OR=3.82). AWI was correlated with the total score of IIEF-15 (r=0.78, p value <0.001).
To improve the QOL of diabetic patients, it is suggested that all the predictors of sexual dysfunction, such as glycaemic control, obesity, diabetes complications and duration, should be considered in diabetic management guidelines.
本研究旨在确定2型糖尿病（T2D）患者性功能障碍和生活质量（QOL）的预测因素。性功能障碍是糖尿病的一个长期后果，尽管它会对生活质量产生不利影响，但在个人管理中却普遍被忽视。
本研究设计为横断面研究。
伊朗南部设拉子的12个糖尿病中心和诊所。
390名男性T2D患者参与了本项目。纳入标准为年龄在30 - 65岁之间，有至少1年的糖尿病病史，进行过空腹血糖和糖化血红蛋白检测，且愿意参与研究。排除患有精神障碍药物治疗史、心脏病史和肾衰竭史的患者。
生活质量和勃起功能障碍（ED）。问卷采用糖尿病相关生活质量评估（ADDQOL）和国际勃起功能指数（IIEF - 15）。数据采用描述性和分析性统计方法进行报告。
参与者的平均年龄为48.35±9.27岁。参与者的ADDQOL平均加权影响（AWI）评分为 - 3.01，表明糖尿病对他们的生活质量有负面影响。性功能障碍总分的平均值为42.79±22.75，轻度、轻度至中度、中度和重度ED的发生率分别为19%、17.7%、17.2%和24.6%。性功能障碍与年龄（OR = 1.06；95%CI：1.02至1.09）、糖尿病病程（OR = 1.04，95%CI：1.01至1.07）、糖化血红蛋白（OR = 1.45，95%CI：1.07至1.95）、体重指数（OR = 1.10，95%CI：1.03至1.16）、婚姻状况（已婚：OR = 2.30，95%CI：1.40至3.77）、无糖尿病并发症（OR = 0.17，95%CI：0.08至0.31）和胰岛素治疗（OR = 2.86，95%CI：1.67至4.92）显著相关。ADDQOL与年龄（OR = 1.049）、糖化血红蛋白（OR = 2.192）、婚姻状况（已婚：OR = 2.089）、教育程度（高中文凭：OR = 0.337，大学学位：OR = 0.295）、糖尿病并发症（无并发症：OR = 0.372）和胰岛素治疗（OR = 3.82）显著相关。AWI与IIEF - 15总分相关（r = 0.78，p值<0.001）。
为改善糖尿病患者的生活质量，建议在糖尿病管理指南中考虑性功能障碍的所有预测因素，如血糖控制、肥胖、糖尿病并发症和病程。
