The global burden of erectile dysfunction and its associated risk factors in diabetic patients: an umbrella reviews

Abstract

BACKGROUND: Erectile dysfunction is no longer a whisper in the shadows; it's a rising tide threatening the sexual health of millions of men in different regions. In the cases of diabetes, the condition worsens and has a potent cocktail of physical and psychological distress, chipping away at men's confidence, self-esteem, and mental health. This worrying trend shows no signs of slowing down, with projections claiming a staggering 322 million men globally could be affected in the near future. This urgent issue demands immediate attention and action. Thus, this umbrella review intended to estimate the current burden of erectile dysfunction and associated risk factors among diabetic patients in the global context. METHODS: Following PRISMA guidelines, we searched for relevant studies in PubMed, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. These studies reported the prevalence of erectile dysfunction and associated risk factors in diabetic patients. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews 2 tool. To estimate the pooled prevalence of erectile dysfunction, we employed a weighted inverse variance random-effects model. We further conducted subgroup analyses, assessed heterogeneity and publication bias, and performed sensitivity analyses to strengthen the robustness of our findings. Prediction intervals were also calculated to estimate the range within which future observations will likely fall. In all statistical analyses, the statistical significance was declared at P- value < 0.05. RESULTS: In this umbrella review, a total of 108 030 male diabetic patients were included to estimate the global prevalence of erectile dysfunction. The pooled global prevalence of erectile dysfunction in diabetic patients was 65.8% (95CI: 58.3 - 73.3%), while In Africa it was 62.9% (95CI: 46.1-79.7). Age (> 40 years) (AOR = 1.95, 95CI: 1.03-3.24), DM duration (> 10years) (AOR = 1.90,95CI: 1.16-2.65), peripheral vascular disease (AOR = 2.74, 95CI: 1.42-4.06) and BMI (> 30 kg/m2) (AOR = 1.07,95CI: 1.01-1.20) were identified as associated risk factors of erectile dysfunction in diabetic patient. CONCLUSION: The high global prevalence of erectile dysfunction (ED) in diabetic patients is alarming, with an estimated two-thirds experiencing the condition. These findings underscore the significant burden of ED faced by diabetic men and emphasize the urgent need for global attention to the issue. This includes promoting early screening for erectile dysfunction in this population and ensuring access to appropriate treatment and support.