To identify predictors of poor quality of life among men with diabetes from a comprehensive set of sexual, clinical, socio-economic and lifestyle variables.Methods
This was a cross-sectional observational-study of 253 men with Type 2 diabetes, randomly selected from a clinic in Colombo, Sri Lanka. Erectile dysfunction was assessed using the five-item International Index of Erectile Function and quality of life was assessed using the Sri Lankan version of the 36-item short form health survey questionnaire and the disease-specific Psychological Impact of Erectile Dysfunction scale. The presence of premature ejaculation, reduced libido, socio-demographic and lifestyle data was obtained using an interviewer-administered questionnaire. Significant predictors of quality of life were identified by stepwise multivariate linear regression models for short form-36 subscales, summary scales and two scales of Psychological Impact of Erectile Dysfunction.Results
Significant predictors on the physical summary scale of the 36-item short form were erectile dysfunction (β = 7.93, 95% CI 3.70–12.17, P < 0.001) and reduced libido (β = 5.20, 95% CI 0.82–9.59, P < 0.05). Predictors on the mental health summary scale of the 36-item short form were erectile dysfunction (β = 5.82, 95% CI 2.26–9.37, P < 0.01), BMI > 27.5 kg/m2 (β = 9.12, 95% CI 1.38–17.44, P < 0.05), ischaemic heart disease (β = 6.39, 95% CI 0.74–12.04, P < 0.05) and insulin therapy (β = 5.28, 95% CI 0.34–10.22, P < 0.05). Significant predictors in the sexual experience scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 6.57, 95% CI 4.63–8.51, P < 0.001), reduced libido (β =4.33, 95% CI 2.34–6.32, P < 0.001) and postural hypotension (β = 3.99, 95% CI 0.13–7.85, P < 0.05). Predictors on the emotional life scale of the Psychological Impact of Erectile Dysfunction were erectile dysfunction (β = 2.96, 95% CI 1.37–4.58, P < 0.001), reduced libido 2.75 (β = 2.75, 95% CI 1.12–4.40, P < 0.01), younger age (β = 1.05, 95% CI 0.35–1.75, P < 0.01) and postural hypotension (β = 3.39, 95% CI 0.35–6.45, P < 0.05).Conclusion
Erectile dysfunction was a strong predictor of poor generic and disease-specific quality of life among other sexual and clinical variables in men with diabetes.