The impact of erectile dysfunction and its treatment with phosphodiesterase type-5 (PDE5) inhibitors in patients with diabetes

摘要

Men with diabetes are prone to cardiovascular and neurological complications that can result in a higher incidence of erectile dysfunction (ED) than in the general population. Management of ED is similar to that in men without diabetes, with the goal of restoring the sex life the patient had previously enjoyed. Treatments for ED must be suitable for patients with diabetes with or without comorbidities and should not interfere with metabolic control or existing medications.The oral phosphodiesterase type-5 (PDE5) inhibitors are the first-line treatment for most causes of ED in men with diabetes. They promote smooth muscle relaxation by blocking the hydrolysis of cyclic guanosine monophosphate (cGMP). All commercially available PDE5 inhibitors (sildenafil, vardenafil and tadalafil) are effective with minimal side effects in both the general ED population and patients with diabetes. Tadalafil has pharmacokinetic properties different from those of sildenafil and vardenafil. Tadalafil, however, has a long half-life producing a broad period of responsiveness and its pharmacokinetics are not altered by food. These properties give patients with diabetes and ED, and their partners, further freedom in choosing when to have sex.