OBJECTIVETo investigate the relationship of erectile dysfunction (ED) with blood vessel-, nerve- and androgen-related factors in young and middle-aged men with type 2 diabetes mellitus (T2DM) in order to provide some clinical evidence for early prevention and treatment of ED.

METHODSWe divided 53 male T2DM patients under 50 years into an ED group (IIEF-5 score < or = 21, n = 28) and a non-ED (NED) group (IIEF-5 score > or = 22, n = 25). We detected the levels of blood lipid, glucose, total testosterone (TT), sex hormone-binding globulin (SHBG), sulfate dehydroepiandrosterone (DHEA-S), calculated free testosterone (cFT), and examined the complications of macroangiopathy (MA), diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN), and compared the above indicators between the two groups.

RESULTSThere were no significant differences between the two groups in age, diabetes duration, body mass index, blood pressure, and blood lipid and glucose levels (P > 0.05). The incidence rate of DR was significantly higher in the ED than in the NED group (39.3% vs 4.0%, P < 0.05), but no statistically significant differences were found in the levels of TT, cFT, SHBG and DHEA-S and the incidence rates of MA and DPN between the two groups (P > 0.05).

CONCLUSIONThe incidence of ED is closely related to DR in young and middle-aged men with T2DM. Therefore particular attention should be paid to the erectile function of T2DM patients with DR as early as possible.

Adult ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; complications ; Diabetic Retinopathy ; complications ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged

Cardiovascular Diseases ; epidemiology ; etiology ; China ; epidemiology ; Diabetes Complications ; complications ; epidemiology ; Diabetic Foot ; epidemiology ; etiology ; Diabetic Nephropathies ; epidemiology ; etiology ; Diabetic Neuropathies ; epidemiology ; etiology ; Diabetic Retinopathy ; epidemiology ; etiology ; Humans

Recently chronic angiopathy of diabetes mellitus has become serious complication of diabetes mellitus. Chronic angiopathic complication of diabetes mellitus is divided into macrovascular disease and microvascular disease. Macrovascular disease includes coronary arterial disease, cerebrovascular disease, foot lesion and microvascular disease includes diabetic retinopathy, nephropathy and neuropathy. It is well known that microvascular disease'is relatively unique in diabetic patients and macrovascular disease is frequently found in non diabetic patients, although prevalence rate is still high in diabetic patients. This finding supports the view that microvascular disease and macrovascular disease have different pathogenesis. The authors evaluated and invested the 180 patients with diabetes mellitus who have taken neurologic examination and NCV studies f rom January 1, 1990 to September 30, 1992. The results were as followed: 1.There is a significant tendency that diabetic patients with neuropathy are accompanied by other microangiopathy (retinopathy or nephropathy) than diabetic patients without neuropathy. 2.Between diabetic patients with peripheral neuropathy and without peripheral neuropathy, there is no difference in the prevalence of macroangiopathy.
Diabetes Complications* ; Diabetes Mellitus ; Diabetic Neuropathies* ; Diabetic Retinopathy ; Foot Diseases ; Humans ; Neurologic Examination ; Peripheral Nervous System Diseases ; Prevalence

The morbidity and mortality associated with diabetic complications impose a huge socioeconomic burden worldwide. Therefore, the ultimate goal of managing diabetes mellitus (DM) is to lower the risk of macrovascular complications and highly morbid microvascular complications such as diabetic nephropathy (DN) and diabetic retinopathy (DR). Potential benefits of incretin-based therapies such as glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors on the diabetic macrovascular complications have been recently suggested, owing to their pleiotropic effects on multiple organ systems. However, studies primarily investigating the role of these therapies in diabetic microvascular complications are rare. Nevertheless, preclinical and limited clinical data suggest the potential protective effect of incretin-based agents against DN and DR via their anti-inflammatory, antioxidative, and antiapoptotic properties. Evidence also suggests that these incretin-dependent and independent beneficial effects are not necessarily associated with the glucose-lowering properties of GLP-1 RAs and DPP-4 inhibitors. Hence, in this review, we revisit the preclinical and clinical evidence of incretin-based therapy for DR and DN, the two most common, morbid complications in individuals with DM. In addition, the review discusses a few recent studies raising concerns of aggravating DR with the use of incretin-based therapies.
Diabetes Complications ; Diabetes Mellitus ; Diabetic Nephropathies ; Diabetic Retinopathy ; Dipeptidyl-Peptidase IV Inhibitors ; Glucagon-Like Peptide 1 ; Mortality

Diabetic kidney disease, as one of the important diabetic complication, developed in 20% to 40% of patients with diabetes and is now the most common cause of end-stage renal disease. Although it has been recommended that annual screening of renal function including microalbuminuria in diabetic patients, many patients are currently under-diagnosed state. Early recognition of diabetic renal complication has a pivotal role in the management of diabetic patients for improvement of patient's prognosis. The detection of microalbuminuria is particularly important as a marker of early diabetic kidney disease, and is related with an elevated cardiovascular complications. Like other chronic renal disease, diabetic kidney disease has characteristic to show a progressive decline in renal function, but significantly increased cardiovascular mortality even in the early stage of diabetic kidney disease. Therefore, more aggressive trials for detection of the presence of diabetic kidney disease and comorbid cardiovascular disease and management for cardiovascular risk factor reduction and adequate therapeutic intervention for slowing the progression of renal disease is essential to proper management for patients with diabetic kidney disease.
Cardiovascular Diseases ; Diabetes Complications ; Diabetic Nephropathies ; Diabetic Retinopathy ; Humans ; Kidney Failure, Chronic ; Mass Screening ; Prognosis ; Renal Insufficiency, Chronic ; Risk Factors

Diabetic kidney disease, as one of the important diabetic complication, developed in 20% to 40% of patients with diabetes and is now the most common cause of end-stage renal disease. Although it has been recommended that annual screening of renal function including microalbuminuria in diabetic patients, many patients are currently under-diagnosed state. Early recognition of diabetic renal complication has a pivotal role in the management of diabetic patients for improvement of patient's prognosis. The detection of microalbuminuria is particularly important as a marker of early diabetic kidney disease, and is related with an elevated cardiovascular complications. Like other chronic renal disease, diabetic kidney disease has characteristic to show a progressive decline in renal function, but significantly increased cardiovascular mortality even in the early stage of diabetic kidney disease. Therefore, more aggressive trials for detection of the presence of diabetic kidney disease and comorbid cardiovascular disease and management for cardiovascular risk factor reduction and adequate therapeutic intervention for slowing the progression of renal disease is essential to proper management for patients with diabetic kidney disease.
Cardiovascular Diseases ; Diabetes Complications ; Diabetic Nephropathies ; Diabetic Retinopathy ; Humans ; Kidney Failure, Chronic ; Mass Screening ; Prognosis ; Renal Insufficiency, Chronic ; Risk Factors

PURPOSE: This study investigated the long-term anatomic and visual results in patients having vitrectomies for proliferative diabetic retinopathy complications by comparing the results of postoperative 6 months and the results of 3 years or later. Subject and Method : Medical records of 139 eyes which had undergone pars plana vitrectomy for proliferative diabetic retinopathy complications and had been followed more than 3 years were reviewed. RESULT: Eighty eight of 139 eyes (63.3%) showed better visual acuity at 6 months postoperatively than at baseline, 24 eyes (17.3%) had same visual acuities, and 27 eyes (19.4%) had poorer vision. At the last follow-up vision improved in 90 eyes (64.7%), remained same in 23 eyes (16.5%), and decreased in 26 eyes (18.7%). Compared with the visual acuity of postoperative 6 months, vision of the last follow-up was better in 22 eyes (15.9%), same in 94 eyes (67.6%), and poorer in 23 eyes (16.5%). Of 112 eyes which had anatomic success at the 6 months postoperatively, 99 eyes (88.4%) remained to have anatomic success at the last follow-up. CONCLUSION: In patients undergoing vitrectomies for proliferative diabetic retinopathy complications, postoperative visual acuity and anatomic success at the 6 months were maintained at the longer follow-up of 3.7 years in average.
Diabetic Retinopathy* ; Follow-Up Studies ; Humans ; Medical Records ; Postoperative Complications ; Visual Acuity ; Vitrectomy*

We compared the visual outcome after phacoemulsification through the scleral pocket incision between non-diabetic patients and diabetic patients, and studied the factors influencing the visual outcome and postoperative complications in diabetic patients. retrospectively. The subjects operated by one of the authors were composed of 277 non-diabetic patients (277 eyes) and 90 diabetic patients (113 eyes). An average of the best corrected visual acuities at postoperative 8 weeks was lower in diabetic patients than that in non-diabetic patients, but there was no statistically significant difference between diabetic patients who had no or background diabetic retinopathy and non-diabetic patients. In diabetic patients the visual outcome was significantly related with severity of diabetic retinopathy, duration of the diabetes, and insulin dependency, but not related with the rupture of posterior capsule during surgery. Among the complications there were posterior capsule rupture (10.6%), hyphema (7.8%), posterior capsular opacity (4.9%), and posterior synechiae (4.9%).
Diabetic Retinopathy ; Humans ; Hyphema ; Insulin ; Phacoemulsification* ; Postoperative Complications ; Retrospective Studies ; Rupture ; Visual Acuity

PURPOSE: To investigate the knowledge and awareness level of diabetic retinopathy (DR) in type 2 diabetes patients. METHODS: A total of 437 participants with diabetes were recruited in the Seoul Metro-City Diabetes Prevention Program (SMC-DPP). Participants underwent clinical and laboratory examinations and questionnaire survey to evaluate diabetes complications. The DR was diagnosed by grading fundus photographs 5 standard fields taken per eye. RESULTS: The overall prevalence of any DR was 20.4% and only 6.6% of patients were aware of their DR. The DR patients who underwent an eye examination within the previous year were 42.3%, and 50.3% out of 437 patients enrolled were educated on diabetes. Of the survey participants, 83.8% answered positive to 'Evaluation of diabetes mellitus complication must be performed every year', 61.1% answered positive to 'Must control blood pressure and lipid level for diabetes management' and 28.4% believed 'It takes a long time for complications of diabetes to develop'. The DR self awareness was 14.6% and an eye examination within the previous year was 50.6% among the 89 DR participants. CONCLUSIONS: Results of the survey with SMC-DPP type 2 diabetes participants showed a low knowledge and awareness level of chronic complications such as DR.
Blood Pressure ; Diabetes Complications ; Diabetic Retinopathy ; Eye ; Humans ; Prevalence ; Surveys and Questionnaires

PURPOSE: We compared the surgical outcomes of vitrectomy for proliferative diabetic retinopathy between younger and older groups. METHODS: We reviewed the data of 185 patients (227 eyes) who had undergone vitrectomy and endolaser photocoagulation and who were followed up for at least 6 months. We divided them into two age-based groups: less than 40 years of age (52 eyes), and more than 40 years of age (175 eyes). We compared preoperative status, surgical outcomes, and postoperative complications. RESULTS: Postoperative visual acuity improved in 75.0% in the younger group, and 68.6% in the older group, and the difference was not statistically significant. The proportion of eyes with good visual acuity of 0.6 or better was statistically significantly (Ed-confirm this addition) higher in the younger group (30.8%) than in the older group (17.1%). The proportion of eyes with postoperative visual acuity of no light perception was statistically significantly higher in the younger group. The visual acuity in the patients who lacked photocoagulation was poorer in the younger group. Postoperative recurrent vitreous hemorrhage, corneal epithelial defect, and additional operation rate was more prevalent in the younger group. CONCLUSIONS: We found no significant difference in the overall postoperative results between younger and older patients. Early panretinal photocoagulation and vitrectomy can be helpful to maintain visual function of young patients. Special care is needed to prevent postoperative complications.
Diabetic Retinopathy* ; Humans ; Light Coagulation ; Postoperative Complications ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Young Adult