Predictive factors of sexual dysfunction and quality of life among type 2 diabetes outpatients in southern Iran: a cross-sectional survey.

OBJECTIVES

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.

DESIGN

This research was designed as a cross-sectional study.

SETTING

12 diabetes centres and clinics in Shiraz, south of Iran.

PARTICIPANTS

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.

PRIMARY OUTCOME MEASURES: 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.

RESULT: 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).

CONCLUSION

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.