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Horm Metab Res
DOI: 10.1055/a-2813-5608
Original Article: Endocrine Care

Prevalence, Incidence, and Remission of Erectile Dysfunction in Newly Diagnosed and Uncomplicated Type 2 Diabetic Men: The Role of Testosterone, Hyperuricemia, and Patient Education

Authors

  • Adriana Coppola

    1   Endocrinology, Diabetes and Metabolism Unit, Istituto Clinico Beato Matteo, Vigevano, Italy (Ringgold ID: RIN46782)

  • Pietro Gallotti

    2   Internal Medicine Unit, Istituto Clinico Beato Matteo, Vigevano, Italy (Ringgold ID: RIN46782)

  • Carmelo Pujia

    3   Department of Experimental and Clinical Medicine, University of Catanzaro, Catanzaro, Italy (Ringgold ID: RIN9325)

  • Tiziana Montalcini

    3   Department of Experimental and Clinical Medicine, University of Catanzaro, Catanzaro, Italy (Ringgold ID: RIN9325)

  • Colomba Falcone

    4   Centro Interdipartimentale di Medicina Molecolare per la Diagnosi e la Cura delle Malattie Cardiovascolari e Metaboliche (CIRMC), University of Pavia, Pavia, Italy (Ringgold ID: RIN19001)
    5   Cardiology Unit, Istituto di Cura Citta di Pavia, Pavia, Italy (Ringgold ID: RIN46777)

  • Carmine Gazzaruso

    1   Endocrinology, Diabetes and Metabolism Unit, Istituto Clinico Beato Matteo, Vigevano, Italy (Ringgold ID: RIN46782)
    6   Department of Biomedical Sciences for Health, University of Milan, Milan, Italy (Ringgold ID: RIN9304)
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Abstract

In type 2 diabetes mellitus, the prevalence at diagnosis, incidence, and remission of erectile dysfunction are unknown. We evaluated the prevalence, incidence, remission, and predictors of erectile dysfunction in newly diagnosed and uncomplicated type 2 diabetic men. We consecutively enrolled 549 diabetic men without complications. Erectile dysfunction was diagnosed using the International Index for Erectile Function 5 questionnaire. Patients were followed up for 64.2±22.1 months. At baseline, 133 patients had erectile dysfunction and 416 patients did not. The prevalence of erectile dysfunction was 24.2%. Among the 416 patients without erectile dysfunction at baseline, 67 (16.1%) patients developed erectile dysfunction at follow-up, with an erectile dysfunction incidence of 2.3%/y. Among the 133 patients with erectile dysfunction at baseline, 27 (20.3%) patients had remission at follow-up, with an erectile dysfunction remission rate of 0.9%/y. Multivariate analysis showed that age>60 years, total testosterone levels of<2.8 ng/mL and uric acid levels of>6 mg/dL were predictors of erectile dysfunction at diagnosis. Predictors of erectile dysfunction incidence were age>60 years, smoking and low total testosterone levels, whereas total testosterone levels of>2.8 ng/mL predicted erectile dysfunction remission. No significant association between therapeutic patient education and erectile dysfunction was observed. In conclusion, one quarter of men with newly diagnosed and uncomplicated type 2 diabetes has erectile dysfunction at diagnosis. The incidence of erectile dysfunction was 2.3%/y, while remission was 0.9%/y. Older age, low total testosterone levels, and hyperuricemia were associated with erectile dysfunction at diabetes diagnosis, while older age, smoking, and total testosterone levels were the longitudinal predictors of erectile dysfunction.

Keywords

diabetes - type 2 diabetes - erectile dysfunction - testosterone - patient education - uric acid


Publication History

Received: 19 October 2025

Accepted after revision: 13 February 2026

Article published online:
02 March 2026

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