by ARPANDEV BHATTACHARYYA and PHILIP G. WILES
Diabetes Annual, 1998; Chapter 12: pp 195-219.
The diagnosis of diabetes mellitus places a burden not only on the diabetic patient, but also on his or her family. Restrictions, of varying intrusiveness, are placed on former habits and lifestyle, affecting both patient and family. The spectre of long term complication hangs over the patient and come, with time, increasingly to the fore. Families often adopt an important supportive, even protective, role with some patients becoming reliant on partners to help manage their diabetes and cope with the intrusion on their lives. With this background, the development of sexual dysfunction may assume an importance to the patient and his or her partner, the magnitude of which is frequently underestimated by those professional in their care.
Sexual dysfunction as a long term complication of diabetes mellitus has often been neglected in the past or been overshadowed by the more sinister complication of slight threatening retinopathy, diabetic nephropathy leading to chronic renal failure and severe diabetic foot disease. However, sexual dysfunction in diabetic patients may cause acute emotional problems, considerable reduction in quality of life and can lead to breakdown of relationship. Diabetes is probably the most common organic cause of sexual impotence in men, having been recognized for almost 200 years. In contrast, sexual problems of diabetic women have received scant attention. With the advancement of knowledge about sexual disorders in diabetes and with increasing availability of different modes of treatment, there is a rush of enthusiasm for this previously neglected subject. This chapter discusses the problems, the recognition in male and female diabetic patients.