Skip to main content
SpringerLink
Log in

Association of erectile dysfunction with diabetic foot and its outcomes in type 2 diabetic men

  • Original Article
  • Published:
Hormones Aims and scope Submit manuscript

Abstract

Purpose

Erectile dysfunction (ED) and diabetic foot (DF) are common complications in patients with diabetes. However, the relationship between ED and DF has been little studied. In particular, no study has evaluated whether ED is associated with the outcomes of DF. The aim of this retrospective cohort study was to investigate whether ED is a predictor of the outcomes of DF in a large population of men with DF.

Methods

Three hundred and twenty-six consecutive men with type 2 diabetes and a recent and single DF ulcer were recruited and followed up for 41.7 ± 22.7 months.

Results

Among men with DF, 56.1% had ED (ED group) and 43.9% did not (NO ED group). Wound healing rate was significantly higher in the NO ED than in the ED group (90.2 versus 73.3%; p = 0.0001). Minor amputation rate (13.7 versus 4.8%; p = 0.007) and mortality (25.7 versus 0.7%; p < 0.001) were significantly greater in the ED than in the NO ED group. Among 263 patients with healed ulcers, recurrence rate was significantly higher in the ED than in the NO ED group (51.5 versus 26.3%; p < 0.001). Multivariate analysis showed that the absence of ED was associated with wound healing (OR: 0.459; 95% CI: 0.213–0.993; p = 0.048), while the presence of ED predicted mortality (OR: 22.644; 95% CI: 2.976–34.271; p = 0.002) and DF recurrence (OR: 3.498; 95% CI: 1.882–6.499; p < 0.001).

Conclusions

Our data show that among men with DF the prevalence of ED is very high. Moreover, ED may be a strong predictor of wound healing, mortality, and ulcer recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gazzaruso C, Coppola A, Giustina A (2011) Erectile dysfunction and coronary artery disease in patients with diabetes. Curr Diabetes Rev 7:143–147

    Article  PubMed  Google Scholar 

  2. Fedele D, Coscelli C, Cucinotta D, Forti G, Santeusanio F, Viaggi S, Fiori G, Velonà T, Lavezzari M, Diade Study Group (2001) Incidence of erectile dysfunction in Italian men with diabetes. J Urol 166:1368–1371

    Article  CAS  PubMed  Google Scholar 

  3. Ma RC, So WY, Yang X, Yu LW, Kong AP, Ko GT, Chow CC, Cockram CS, Chan JC, Tong PC (2008) Erectile dysfunction predicts coronary heart disease in type 2 diabetes. J Am Coll Cardiol 51:2045–2050

    Article  PubMed  Google Scholar 

  4. Gazzaruso C, Solerte SB, Pujia A, Coppola A, Vezzoli M, Salvucci F, Valenti C, Giustina A, Garzaniti A (2008) Erectile dysfunction as a predictor of cardiovascular events and death in diabetic patients with angiographically proven asymptomatic coronary artery disease: a potential protective role for statins and 5-phosphodiesterase inhibitors. J Am Coll Cardiol 51:2040–2044

    Article  PubMed  Google Scholar 

  5. Armstrong DG, Boulton AJM, Bus SA (2017) Diabetic foot ulcers and their recurrence. N Engl J Med 376:2367–2375

    Article  PubMed  Google Scholar 

  6. Jeffcoate WJ, Vileikyte L, Boyko EJ, Armstrong DG, Boulton AJM (2018) Current challenges and opportunities in the prevention and management of diabetic foot ulcers. Diabetes Care 41:645–652

    Article  PubMed  Google Scholar 

  7. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y (2017) Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis. Ann Med 49:106–116

    Article  PubMed  Google Scholar 

  8. Han PY, Ezquerro R, Pan KM, Hwang S, Chung Y, Lu JJ (2003) Comorbidities associated with diabetic foot complications among Asian Americans in southern California. J Am Podiatr Med Assoc 93:37–41

    Article  PubMed  Google Scholar 

  9. Gazzaruso C, Gallotti P, Pujia A, Montalcini T, Giustina A, Coppola A (2021) Predictors of healing, ulcer recurrence and persistence, amputation and mortality in type 2 diabetic patients with diabetic foot: a ten-year retrospective cohort study. Endocrine 71:59–68

    Article  CAS  PubMed  Google Scholar 

  10. Rosen RC, Cappelleri JC, Smith MD et al (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11:319–326

    Article  CAS  PubMed  Google Scholar 

  11. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifugate. Clin Chem 18:499–502

    Article  CAS  PubMed  Google Scholar 

  12. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  CAS  PubMed  Google Scholar 

  13. Gazzaruso C, Garzaniti A, Giordanetti S, Falcone C, Fratino P (2002) Silent coronary artery disease in type 2 diabetes mellitus: the role of lipoprotein(a), homocysteine and apo(a) polymorphism. Cardiovasc Diabetol 22:1–5

    Google Scholar 

  14. Gazzaruso C, Solerte SB, De Amici E et al (2006) Association of the metabolic syndrome and insulin resistance with silent myocardial ischemia in patients with type 2 diabetes mellitus. Am J Cardiol 97:236–239

    Article  CAS  PubMed  Google Scholar 

  15. Gazzaruso C, Coppola A, Montalcini T et al (2012) Screening for asymptomatic coronary artery disease can reduce cardiovascular mortality in type 2 diabetic patients. Intern Emerg Med 7:257–266

    Article  PubMed  Google Scholar 

  16. Gazzaruso C, Coppola A, Montalcini T et al (2012) Lipoprotein(a) and homocysteine as genetic risk factors for vascular and neuropathic diabetic foot in type 2 diabetes mellitus. Endocrine 41:89–95

    Article  CAS  PubMed  Google Scholar 

  17. Gazzaruso C, Coppola A, Falcone C et al (2013) Transcutaneous oxygen tension as a potential predictor of cardiovascular events in type 2 diabetes: comparison with ankle-brachial index. Diabetes Care 36:1720–1725

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Gazzaruso C, Pujia A, Solerte SB et al (2006) Erectile dysfunction and angiographic extent of coronary artery disease in type II diabetic patients. Int J Impot Res 18:311–315

    Article  CAS  PubMed  Google Scholar 

  19. Montorsi P, Ravagnani PM, Galli S, Rotatori F, Briganti A, Salonia A, Rigatti P, Montorsi F (2005) The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol 96:19M-23M

    Article  PubMed  Google Scholar 

  20. Liu LH, Zhang T, Zhang YR, Liu TS, Zhang HB, Chen FZ, He SH, Wei AY (2014) Metabolic syndrome and risk for ED: a meta-analysis. Int J Impot Res 26:196–200

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diabetes and Endocrine-Metabolic Diseases Unit, Istituto Clinico Beato Matteo, Gruppo Ospedaliero San Donato, Corso Pavia 84, 27029, Vigevano, Italy

    Adriana Coppola, Pietro Gallotti & Carmine Gazzaruso

  2. Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy

    Tiziana Montalcini & Arturo Pujia

  3. Department of Endocrinology, IRCCS Multimedica, Milan, Italy

    Ileana Terruzzi & Livio Luzi

  4. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy

    Ileana Terruzzi, Livio Luzi & Carmine Gazzaruso

Authors
  1. Adriana Coppola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pietro Gallotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tiziana Montalcini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ileana Terruzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arturo Pujia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Livio Luzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carmine Gazzaruso
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AC and CG were the principal investigators, designed the study, wrote the article, and participated in all the analyses and interpretation of the data; IT and AP also performed the statistical analysis; TM, PG and LL participated in the study design and collected and checked the data; AC and CG were responsible for overall supervision of the research and interpretation of the data. All the investigators contributed to the writing, reviewing and editing of the paper and approved the final version.

Corresponding author

Correspondence to Carmine Gazzaruso.

Ethics declarations

Ethical approval

This study was approved by the local Institutional Review Board.

Informed consent

This study used information previously collected during normal care (with no intention of using it for research purpose at the time of collection). The data set used was fully anonymized to the authors. Therefore, no informed consent was required from the patients for being included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Coppola, A., Gallotti, P., Montalcini, T. et al. Association of erectile dysfunction with diabetic foot and its outcomes in type 2 diabetic men. Hormones 22, 45–50 (2023). https://doi.org/10.1007/s42000-022-00407-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42000-022-00407-5

Keywords

Search

Navigation