Abstract:
Background: Erectile dysfunction in men is a common underestimated complication of diabetes
mellitus, which is becoming a significant public health problem both in developing and
developed countries. Erectile dysfunction threatens the well-being of clients, hence determining
its risk factors and controlling it at an early stage is vital to preventing serious consequences and
the burden of the disease. Therefore, this study aimed to systematically evaluate erectile
dysfunction risk factors in patients with diabetes mellitus in Africa.
Methods: PubMed, Web of Science, Scopus, African Journals Online, Wiley Online Library and
Google Scholar were searched and complemented by manual searches. Egger's regression test
was used to determine publication bias. The I2
statistic was used to check heterogeneity between
the studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect
size, odds ratios, and 95% confidence interval across studies. STATA version 14 statistical
software was used for the meta-analysis.
Result: Overall, 17 studies with 6002 study participants were included to identify risk factors of
erectile dysfunction among diabetic patients. Duration of diabetes mellitus >10 years (AOR =
2.63; 95% CI 1.27, 5.43), age >40 years (AOR = 1.24; 95% CI: 1.03, 1.51), peripheral
neuropathy (AOR = 2.34; 95% CI: 1.51, 10.72), no physical exercise (AOR = 1.63; 95% CI:
1.49, 1.78), testosterone level <8 nmol/l (AOR = 2.83; 95% CI: 1.06, 12.86), and peripheral
vascular disease (AOR = 2.85, 95% CI: 1.54-5.27) were significantly associated with erectile
dysfunction among diabetic patients.
Conclusions: This study found that long duration of diabetes mellitus, age >40 years,
testosterone deficiency, peripheral neuropathy, not involved in physical exercise, peripheral
vascular disease, were significantly associated with increased risk of erectile dysfunction among
diabetic patients Therefore, situation-based interventions and country context-specific preventive
strategies should be developed to decrease the risk factors of erectile dysfunction among patients
with diabetes mellitus.
