Severe Hypoglycemia, High Anxiety, and Depressive Symptoms Are Associated with Erectile Dysfunction in Male Adults with Type 1 Diabetes in a Brazilian Tertiary Hospital

DM is the comorbidity that exerts the greatest risk for erectile dysfunction (ED). Studies have demonstrated a higher prevalence of sexual hormones’ disorders and depression in this population. There are few studies evaluating these aspects in persons with T1D (PWT1D). This study aimed to describe the frequency of ED in male adults with T1D (MAWT1D) followed in a Brazilian tertiary hospital and verify which sociodemographic, clinical, and laboratory factors were related to ED. In a cross-sectional study, 48 MAWT1D were evaluated. Inclusion criteria were T1D diagnosis for ≥ 5 years and age ≥ 18 years. We excluded MAWT1D in which other clinical conditions were present (e.g. COVID-19 infection, alcohol abuse). Patients’ characteristics were evaluated through medical records and a standard questionnaire displayed by Google Forms. Severe hypoglycemia was defined when PWT1D required another person assistance. Sexual hormones were measured by electrochemiluminescence and free androgen index (FAI) was calculated by multiplying total testosterone (ng/ml) by 347, then dividing by the sex hormone binding globulin (nmol/L). The scale 5-Item Version of the International Index of Erectile Dysfunction (IIEF-5) assessed ED. The Hospital Anxiety and Depression Scale - HAD measured anxiety and depressive symptoms (Cut point ≥ 8 indicated clinically relevant symptoms). Continuous and categorical measures were analyzed by Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher’s exact test (p<5%). The participants’ average age was 35.5 ± 12.6 years, and mean years of T1D diagnosis was 22.08 ± 11.2 years. The ED frequency was 52.08%. The associated factors were: severe hypoglycemia (p= 0.0007), HAD/D and HAD/A ≥ 8 (p=0.0184 and p = 0.0042, respectively). FAI was lower in ED group (0.0410). Conclusion: ED frequency is high in MAWT1D and its associated factors should be mitigated to improve ED and quality of life in this population. Disclosure P. R. Jaskulski: None. E. J. Pavin: None. M. S. Silveira: None. M. B. Koelle: None.