Mechanism of erectile dysfunction in people with diabetes

A meta-analytical study found that patients with diabetes were 2 times more likely to develop depression than those without diabetes. The occurrence of erectile dysfunction exacerbates the manifestations of depression, anxiety increases especially when there is a lack of support from a partner. These make sexual dysfunction and erectile dysfunction more and more severe.
Patients with diabetes have functional and structural abnormalities of the vascular endothelium. Nitric oxide (NO) is synthesized from L-arginine by penile artery endothelium and nitregic neurons. NO-mediated vasodilation of the corpus cavernosum and ultimately erection is mediated by cyclic guanosine monophosphate (cGMP). One of the effector proteins for cGMP is CGMP-kinase 1 (PKG-1), which is significantly reduced in diabetic patients. Diabetes mellitus and erectile dysfunction are characterized by elevated levels of endothelin-1, a potent vasoconstrictor and proinflammatory peptide involved in endothelial function, which inhibits NO synthesis.

Insulin resistance in diabetic patients also affects vasodilation based on its effect on NO synthesis. Prolonged hyperglycemia leads to formation of glycerate terminal metabolites. A competitor for NO is dimethylarginine, which is elevated in diabetes and erectile dysfunction. High concentrations lead to endothelial dysfunction and cardiovascular events.
Erectile dysfunction due to neuropathy in diabetic patients. Decreased parasympathetic tone leads to decreased NO synthesis from endothelial cells and neurons. Increased oxidative stress, neurotrophic hypoxia and increased protein kinase C product were further contributed. Peripheral neuropathy includes abnormal sensation going to and from the penis. In men with diabetes, penile nerve dysfunction may precede other peripheral nerve damage.
Low testosterone levels indicate insulin resistance, poor blood sugar control and marked erectile dysfunction. In patients with diabetes, there is decreased levels of sex hormone-binding globulin, a testosterone transporter, decreased secretion of LH and testosterone due to diabetes-associated leptin resistance, high insulin resistance leading to decreased insulin action to the hypothalamus.

Periodic health check-ups help detect diseases early, thereby planning treatment for optimal results. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy, including:
Health checkup package general Standard 2020 General health check-up package VIP 2020 General health check-up package Special 2020 General health check-up package Children 2020 General health examination package Work permit - Issuance of work permits Examination results of people sick will be returned home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties at the Hospital with quality treatment and services. outstanding customer service.