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Current Diabetes Reviews

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ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

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Review Article

Sexual Dysfunction in Men and Women with Diabetes: A Reflection of their Complications?

Author(s): Andrea Sansone, Daniele Mollaioli, Giacomo Ciocca, Erika Limoncin, Elena Colonnello and Emmanuele A. Jannini*

Volume 18, Issue 1, 2022

Published on: 09 March, 2021

Article ID: e030821192147 Pages: 8

DOI: 10.2174/1573399817666210309104740

Price: $65

Abstract

Background: Diabetes mellitus (DM), one of the worldwide leading causes of death, is associated with a plethora of micro- and macro-vascular complications which should be carefully investigated and, in case, treated in order to improve quality of life and reduce the risk of premature mortality.

Objective: The study aimed to investigate and report current evidence with regard to the association between sexual dysfunction and diabetes.

Methods: A detailed analysis of current literature has been performed on PubMed and Scholar in order to retrieve the most relevant findings pertaining to the study topic.

Results: Female and male sexual dysfunction often occurs in diabetes; while cardiovascular complications are clearly involved, psychosexological factors, endocrine complications, and endothelial dysfunction all contribute to the pathogenesis of sexual dysfunctions. Psychological symptoms are seldom investigated, yet they should not be overlooked by the clinician; in fact, an interplay between sexual dysfunctions and depressive symptoms has been reported, and beneficial effects in both conditions might be obtained by adequate psychological support. Sexual dysfunctions can also act as early biomarkers of cardiovascular disease, a phenomenon frequently reported in men, in which erectile dysfunction predicts the development of coronary artery disease. Additionally, drug therapies can act in both directions, with treatments for diabetes possibly improving male sexual function and exerting beneficial effects for cardiovascular health being reported for pro-erectile drugs.

Conclusion: Sexual dysfunctions often occur in men and women with diabetes. Investigating micro- and macro-vascular complications might not be enough to prevent the development or worsening of any sexual dysfunction; endocrine and psychological assessments are therefore needed to provide the best chances for adequate treatment.

Keywords: Diabetes, erectile dysfunction, premature ejaculation, female sexual dysfunction, hypogonadism, PDE5 inhibitors, testosterone.

[1]
World Health OrganizationGlobal Report on Diabetes. World Health Organization 2016.
[2]
Filardi T, Ghinassi B, Di Baldassarre A, et al. Cardiomyopathy associated with diabetes: the central role of the cardiomyocyte. Int J Mol Sci 2019; 20(13): E3299.
[http://dx.doi.org/10.3390/ijms20133299] [PMID: 31284374]
[3]
Shamloul R, Ghanem H. Erectile dysfunction. Lancet 2013; 381(9861): 153-65.
[http://dx.doi.org/10.1016/S0140-6736(12)60520-0] [PMID: 23040455]
[4]
Kouidrat Y, Pizzol D, Cosco T, et al. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med 2017; 34(9): 1185-92.
[http://dx.doi.org/10.1111/dme.13403] [PMID: 28722225]
[5]
Pontiroli AE, Cortelazzi D, Morabito A. Female sexual dysfunction and diabetes: a systematic review and meta-analysis. J Sex Med 2013; 10(4): 1044-51.
[http://dx.doi.org/10.1111/jsm.12065] [PMID: 23347454]
[6]
Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018; 138: 271-81.
[http://dx.doi.org/10.1016/j.diabres.2018.02.023] [PMID: 29496507]
[7]
Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol 2005; 96(12B): 19M-23M.
[http://dx.doi.org/10.1016/j.amjcard.2005.07.006] [PMID: 16387561]
[8]
Meller SM, Stilp E, Walker CN, Mena-Hurtado C. The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy. J Invasive Cardiol 2013; 25(6): 313-9.
[PMID: 23735361]
[9]
Sims EA, Danforth E Jr, Horton ES, Bray GA, Glennon JA, Salans LB. Endocrine and metabolic effects of experimental obesity in man. Recent Prog Horm Res 1973; 29: 457-96.
[PMID: 4750591]
[10]
Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006; 444(7121): 840-6.
[http://dx.doi.org/10.1038/nature05482] [PMID: 17167471]
[11]
Corona G, Rastrelli G, Monami M, et al. Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis. Eur J Endocrinol 2013; 168(6): 829-43.
[http://dx.doi.org/10.1530/EJE-12-0955] [PMID: 23482592]
[12]
Allen MS, Walter EE. Health-related lifestyle factors and sexual dysfunction: a meta-analysis of population-based research. J Sex Med 2018; 15(4): 458-75.
[http://dx.doi.org/10.1016/j.jsxm.2018.02.008] [PMID: 29523476]
[13]
Corona G, Isidori AM, Aversa A, Burnett AL, Maggi M. Endocrinologic control of men’s sexual desire and arousal/erection. J Sex Med 2016; 13(3): 317-37.
[http://dx.doi.org/10.1016/j.jsxm.2016.01.007] [PMID: 26944463]
[14]
Sansone A, Romanelli F, Gianfrilli D, Lenzi A. Endocrine evaluation of erectile dysfunction. Endocrine 2014; 46(3): 423-30.
[http://dx.doi.org/10.1007/s12020-014-0254-6] [PMID: 24705931]
[15]
Corona G, Goulis DG, Huhtaniemi I, et al. European Academy of Andrology (EAA) guidelines on investigation, treatment and monitoring of functional hypogonadism in males: Endorsing organization: European Society of Endocrinology. Andrology 2020; 8(5): 970-87.
[http://dx.doi.org/10.1111/andr.12770] [PMID: 32026626]
[16]
Grossmann M. Hypogonadism and male obesity: Focus on unresolved questions. Clin Endocrinol 2018; 89(1): 11-21.
[http://dx.doi.org/10.1111/cen.13723] [PMID: 29683196]
[17]
Haider KS, Haider A, Saad F, et al. Remission of type 2 diabetes following long-term treatment with injectable testosterone undecanoate in patients with hypogonadism and type 2 diabetes: 11-year data from a real-world registry study. Diabetes Obes Metab 2020; 22(11): 2055-68.
[http://dx.doi.org/10.1111/dom.14122] [PMID: 32558149]
[18]
Miner M, Esposito K, Guay A, Montorsi P, Goldstein I. Cardiometabolic risk and female sexual health: the Princeton III summary. J Sex Med 2012; 9(3): 641-51.
[http://dx.doi.org/10.1111/j.1743-6109.2012.02649.x] [PMID: 22372651]
[19]
Carosa E, Sansone A, Jannini EA. Management of endocrine disease: Female sexual dysfunction for the endocrinologist. Eur J Endocrinol 2020; 182(6): R101.
[http://dx.doi.org/10.1530/EJE-19-0903] [PMID: 32234976]
[20]
Rahmanian E, Salari N, Mohammadi M, Jalali R. Evaluation of sexual dysfunction and female sexual dysfunction indicators in women with type 2 diabetes: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11: 73.
[http://dx.doi.org/10.1186/s13098-019-0469-z] [PMID: 31467595]
[21]
Giraldi A, Kristensen E. Sexual dysfunction in women with diabetes mellitus. J Sex Res 2010; 47(2): 199-211.
[http://dx.doi.org/10.1080/00224491003632834] [PMID: 20358461]
[22]
Traish AM, Botchevar E, Kim NN. Biochemical factors modulating female genital sexual arousal physiology. J Sex Med 2010; 7(9): 2925-46.
[http://dx.doi.org/10.1111/j.1743-6109.2010.01903.x] [PMID: 20626599]
[23]
Maseroli E, Fanni E, Cipriani S, et al. Cardiometabolic risk and female sexuality: focus on clitoral vascular resistance. J Sex Med 2016; 13(11): 1651-61.
[http://dx.doi.org/10.1016/j.jsxm.2016.09.009] [PMID: 27692844]
[24]
Coppola A, Gallotti P, Choussos D, Pujia A, Montalcini T, Gazzaruso C. Association between clitoral tissue perfusion and female sexual dysfunction in healthy women of reproductive age: a pilot study. Int J Impot Res 2020; 32(2): 221-5.
[http://dx.doi.org/10.1038/s41443-019-0155-6] [PMID: 31164728]
[25]
Mollaioli D, Ciocca G, Limoncin E, et al. Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reprod Biol Endocrinol 2020; 18(1): 10.
[http://dx.doi.org/10.1186/s12958-019-0557-9] [PMID: 32066450]
[26]
Kolotkin RL, Crosby RD, Gress RE, Hunt SC, Engel SG, Adams TD. Health and health-related quality of life: differences between men and women who seek gastric bypass surgery. Surg Obes Relat Dis 2008; 4(5): 651-8.
[http://dx.doi.org/10.1016/j.soard.2008.04.012] [PMID: 18586572]
[27]
Kolotkin RL, Binks M, Crosby RD, Østbye T, Gress RE, Adams TD. Obesity and sexual quality of life. Obesity 2006; 14(3): 472-9.
[http://dx.doi.org/10.1038/oby.2006.62] [PMID: 16648619]
[28]
Guay AT. ED2: erectile dysfunction = endothelial dysfunction. Endocrinol Metab Clin North Am 2007; 36(2): 453-63.
[http://dx.doi.org/10.1016/j.ecl.2007.03.007] [PMID: 17543729]
[29]
Corona G, Forti G, Maggi M. Why can patients with erectile dysfunction be considered lucky? The association with testosterone deficiency and metabolic syndrome. Aging Male 2008; 11(4): 193-9.
[http://dx.doi.org/10.1080/13685530802468497] [PMID: 19172551]
[30]
Jannini EASM. SM = SM: The interface of systems medicine and sexual medicine for facing non-communicable diseases in a gender-dependent manner. Sex Med Rev 2017; 5(3): 349-64.
[http://dx.doi.org/10.1016/j.sxmr.2017.04.002] [PMID: 28596070]
[31]
Romanelli F, Sansone A, Lenzi A. Erectile dysfunction in aging male. Acta Biomed 2010; 81(Suppl. 1): 89-94.
[PMID: 20518197]
[32]
Isidori AM, Buvat J, Corona G, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment-a systematic review. Eur Urol 2014; 65(1): 99-112.
[http://dx.doi.org/10.1016/j.eururo.2013.08.048] [PMID: 24050791]
[33]
Corona G, Sansone A, Pallotti F, et al. People smoke for nicotine, but lose sexual and reproductive health for tar: a narrative review on the effect of cigarette smoking on male sexuality and reproduction. J Endocrinol Invest 2020; 43(10): 1391-408.
[http://dx.doi.org/10.1007/s40618-020-01257-x] [PMID: 32323225]
[34]
Esposito K, Giugliano D. The metabolic syndrome and inflammation: association or causation? Nutr Metab Cardiovasc Dis 2004; 14(5): 228-32.
[http://dx.doi.org/10.1016/S0939-4753(04)80048-6] [PMID: 15673055]
[35]
Maiorino MI, Bellastella G, Giugliano D, Esposito K. From inflammation to sexual dysfunctions: a journey through diabetes, obesity, and metabolic syndrome. J Endocrinol Invest 2018; 41(11): 1249-58.
[http://dx.doi.org/10.1007/s40618-018-0872-6] [PMID: 29549630]
[36]
Mohamad NV, Wong SK, Wan Hasan WN, et al. The relationship between circulating testosterone and inflammatory cytokines in men. Aging Male 2019; 22(2): 129-40.
[http://dx.doi.org/10.1080/13685538.2018.1482487] [PMID: 29925283]
[37]
Sansone A, Mollaioli D, Ciocca G, et al. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. J Endocrinol Invest 2021; 44(2): 223-31. Published online 2020 Jul 13.
[http://dx.doi.org/10.1007/s40618-020-01350-1] [PMID: 32661947]
[38]
Fedele D, Coscelli C, Santeusanio F, et al. Erectile dysfunction in diabetic subjects in Italy. Gruppo Italiano Studio Deficit Erettile nei Diabetici. Diabetes Care 1998; 21(11): 1973-7.
[http://dx.doi.org/10.2337/diacare.21.11.1973] [PMID: 9802753]
[39]
Boeri L, Capogrosso P, Pederzoli F, et al. Unrecognized prediabetes is highly prevalent in men with erectile dysfunction-results from a cross-sectional study. J Sex Med 2018; 15(8): 1117-24.
[http://dx.doi.org/10.1016/j.jsxm.2018.06.009] [PMID: 30078463]
[40]
Lue TF, Brant WO, Shindel A, Bella AJ. Sexual Dysfunction in Diabetes.Endotext South Dartmouth (MA): MDTextcom, Inc. Feingold, KR 2017.
[41]
Same RV, Miner MM, Blaha MJ, Feldman DI, Billups KL. Erectile dysfunction: an early sign of cardiovascular disease. Curr Cardiovasc Risk Rep 2015; 9: 49.
[http://dx.doi.org/10.1007/s12170-015-0477-y]
[42]
Morano S, Gatti A, Mandosi E, et al. Circulating monocyte oxidative activity is increased in patients with type 2 diabetes and erectile dysfunction. J Urol 2007; 177(2): 655-9.
[http://dx.doi.org/10.1016/j.juro.2006.09.046] [PMID: 17222652]
[43]
Morano S, Mandosi E, Fallarino M, et al. Antioxidant treatment associated with sildenafil reduces monocyte activation and markers of endothelial damage in patients with diabetic erectile dysfunction: a double-blind, placebo-controlled study. Eur Urol 2007; 52(6): 1768-74.
[http://dx.doi.org/10.1016/j.eururo.2007.04.042] [PMID: 17478034]
[44]
Adeva-Andany MM, Funcasta-Calderón R, Fernández-Fernández C, Ameneiros-Rodríguez E, Domínguez-Montero A. Subclinical vascular disease in patients with diabetes is associated with insulin resistance. Diabetes Metab Syndr 2019; 13(3): 2198-206.
[http://dx.doi.org/10.1016/j.dsx.2019.05.025] [PMID: 31235157]
[45]
Raggi P. Screening for atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus: controversies and guidelines. Can J Diabetes 2020; 44(1): 86-92.
[http://dx.doi.org/10.1016/j.jcjd.2019.08.009] [PMID: 31594760]
[46]
Corona G, Jannini EA, Maggi M. Inventories for male and female sexual dysfunctions. Int J Impot Res 2006; 18(3): 236-50.
[http://dx.doi.org/10.1038/sj.ijir.3901410] [PMID: 16267565]
[47]
Maseroli E, Scavello I, Vignozzi L. Cardiometabolic risk and female sexuality-part i. risk factors and potential pathophysiological underpinnings for female vasculogenic sexual dysfunction syndromes. Sex Med Rev 2018; 6(4): 508-24.
[http://dx.doi.org/10.1016/j.sxmr.2018.02.009] [PMID: 29730315]
[48]
Maseroli E, Scavello I, Vignozzi L. Cardiometabolic risk and female sexuality-part II. understanding (and overcoming) gender differences: the key role of an adequate methodological approach. Sex Med Rev 2018; 6(4): 525-34.
[http://dx.doi.org/10.1016/j.sxmr.2018.03.004] [PMID: 29661689]
[49]
Sansone A, Aversa A, Corona G, et al. Management of premature ejaculation: a clinical guideline from the Italian Society of Andrology and Sexual Medicine (SIAMS). J Endocrinol Invest 2021 May; 44(5): 1103-18. Epub 2020 Oct 30.
[http://dx.doi.org/10.1007/s40618-020-01458-4] [PMID: 33128158]
[50]
Jannini EA, Lombardo F, Lenzi A. Correlation between ejaculatory and erectile dysfunction. Int J Androl 2005; 28(Suppl. 2): 40-5.
[http://dx.doi.org/10.1111/j.1365-2605.2005.00593.x] [PMID: 16236063]
[51]
El-Sakka AI. Premature ejaculation in non-insulin-dependent diabetic patients. Int J Androl 2003; 26(6): 329-34.
[http://dx.doi.org/10.1111/j.1365-2605.2003.00433.x] [PMID: 14636217]
[52]
Corona G, Giorda CB, Cucinotta D, Guida P, Nada E. SUBITO-DE study group. The SUBITO-DE study: sexual dysfunction in newly diagnosed type 2 diabetes male patients. J Endocrinol Invest 2013; 36(10): 864-8.
[PMID: 23686080]
[53]
Bellastella G, Maiorino MI, Olita L, Della Volpe E, Giugliano D, Esposito K. Premature ejaculation is associated with glycemic control in Type 1 diabetes. J Sex Med 2015; 12(1): 93-9.
[http://dx.doi.org/10.1111/jsm.12755] [PMID: 25424355]
[54]
Corona G, Giorda CB, Cucinotta D, Guida P, Nada E. Gruppo di studio SUBITO-DE. Sexual dysfunction at the onset of type 2 diabetes: the interplay of depression, hormonal and cardiovascular factors. J Sex Med 2014; 11(8): 2065-73.
[http://dx.doi.org/10.1111/jsm.12601] [PMID: 25041930]
[55]
Maiorino MI, Bellastella G, Della Volpe E, et al. Erectile dysfunction in young men with type 1 diabetes. Int J Impot Res 2017; 29(1): 17-22.
[http://dx.doi.org/10.1038/ijir.2016.38] [PMID: 27654032]
[56]
Goldstein I, Chambers R, Tang W, Stecher V, Hassan T. Realworld observational results from a database of 48 million men in the United States: Relationship of cardiovascular disease, diabetes mellitus and depression with age and erectile dysfunction. Int J Clin Pract 2018; 72(4): e13078.
[http://dx.doi.org/10.1111/ijcp.13078] [PMID: 29569323]
[57]
Albasheer OB, Mahfouz MS, Solan Y, et al. Depression and related risk factors among patients with type 2 diabetes mellitus, Jazan area, KSA: A cross-sectional study. Diabetes Metab Syndr 2018; 12(2): 117-21.
[http://dx.doi.org/10.1016/j.dsx.2017.09.014] [PMID: 29037887]
[58]
Avasthi A, Grover S, Bhansali A, et al. Erectile dysfunction in diabetes mellitus contributes to poor quality of life. Int Rev Psychiatry 2011; 23(1): 93-9.
[http://dx.doi.org/10.3109/09540261.2010.545987] [PMID: 21338304]
[59]
De Berardis G, Franciosi M, Belfiglio M, et al. Quality of Care and Outcomes in Type 2 Diabetes (QuED) Study Group. Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked. Diabetes Care 2002; 25(2): 284-91.
[http://dx.doi.org/10.2337/diacare.25.2.284] [PMID: 11815497]
[60]
Ciocca G, Carosa E, Stornelli M, et al. Post-traumatic stress disorder, coping strategies and type 2 diabetes: psychometric assessment after L’Aquila earthquake. Acta Diabetol 2015; 52(3): 513-21.
[http://dx.doi.org/10.1007/s00592-014-0686-8] [PMID: 25408297]
[61]
Franciosi M, Pellegrini F, De Berardis G, et al. QuED Study Group. The impact of blood glucose self-monitoring on metabolic control and quality of life in type 2 diabetic patients: an urgent need for better educational strategies. Diabetes Care 2001; 24(11): 1870-7.
[http://dx.doi.org/10.2337/diacare.24.11.1870] [PMID: 11679449]
[62]
Enzlin P, Mathieu C, Van Den Bruel A, Vanderschueren D, Demyttenaere K. Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes. Diabetes Care 2003; 26(2): 409-14.
[http://dx.doi.org/10.2337/diacare.26.2.409] [PMID: 12547871]
[63]
Bultrini A, Carosa E, Colpi EM, et al. Possible correlation between type 1 diabetes mellitus and female sexual dysfunction: case report and literature review. J Sex Med 2004; 1(3): 337-40.
[http://dx.doi.org/10.1111/j.1743-6109.04048.x] [PMID: 16422965]
[64]
Maiorino MI, Bellastella G, Castaldo F, Petrizzo M, Giugliano D, Esposito K. Sexual function in young women with type 1 diabetes: the METRO study. J Endocrinol Invest 2017; 40(2): 169-77.
[http://dx.doi.org/10.1007/s40618-016-0542-5] [PMID: 27613610]
[65]
Yenice MG, Danacıoğlu YO, Mert M, et al. Evaluation of factors affecting sexual dysfunction in female patients with diabetes mellitus. Arch Endocrinol Metab 2020; 64(3): 319-25.
[http://dx.doi.org/10.20945/2359-3997000000238] [PMID: 32267365]
[66]
Nowosielski K, Skrzypulec-Plinta V. Mediators of sexual functions in women with diabetes. J Sex Med 2011; 8(9): 2532-45.
[http://dx.doi.org/10.1111/j.1743-6109.2011.02336.x] [PMID: 21676182]
[67]
Bąk E, Marcisz C, Krzemińska S, Dobrzyn-Matusiak D, Foltyn A, Drosdzol-Cop A. Relationships of sexual dysfunction with depression and acceptance of illness in women and men with type 2 diabetes mellitus. Int J Environ Res Public Health 2017; 14(9): E1073. [Internet].
[http://dx.doi.org/10.3390/ijerph14091073] [PMID: 28926936]
[68]
Sansone A, Sansone M, Lenzi A, Romanelli F. Testosterone replacement therapy: the emperor’s new clothes. Rejuvenation Res 2017; 20(1): 9-14.
[http://dx.doi.org/10.1089/rej.2016.1818] [PMID: 27124096]
[69]
Corona G, Rastrelli G, Reisman Y, Sforza A, Maggi M. The safety of available treatments of male hypogonadism in organic and functional hypogonadism. Expert Opin Drug Saf 2018; 17(3): 277-92.
[http://dx.doi.org/10.1080/14740338.2018.1424831] [PMID: 29334271]
[70]
Dolci S, Belmonte A, Santone R, et al. Subcellular localization and regulation of type-1C and type-5 phosphodiesterases. Biochem Biophys Res Commun 2006; 341(3): 837-46.
[http://dx.doi.org/10.1016/j.bbrc.2006.01.035] [PMID: 16455054]
[71]
Prasad S, Wilkinson J, Gatzoulis MA. Sildenafil in primary pulmonary hypertension. N Engl J Med 2000; 343(18): 1342.
[http://dx.doi.org/10.1056/NEJM200011023431814] [PMID: 11183578]
[72]
Yang H-M, Jin S, Jang H, et al. Sildenafil reduces neointimal hyperplasia after angioplasty and inhibits platelet aggregation via activation of cgmp-dependent protein kinase. Sci Rep 2019; 9(1): 7769.
[http://dx.doi.org/10.1038/s41598-019-44190-7] [PMID: 31123275]
[73]
Giannattasio S, Corinaldesi C, Colletti M, et al. The phosphodiesterase 5 inhibitor sildenafil decreases the proinflammatory chemokine IL-8 in diabetic cardiomyopathy: in vivo and in vitro evidence. J Endocrinol Invest 2019; 42(6): 715-25.
[http://dx.doi.org/10.1007/s40618-018-0977-y] [PMID: 30415310]
[74]
Anderson SG, Hutchings DC, Woodward M, et al. Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality. Heart 2016; 102(21): 1750-6.
[http://dx.doi.org/10.1136/heartjnl-2015-309223] [PMID: 27465053]
[75]
Saisho Y. Metformin and inflammation: its potential beyond glucose-lowering effect. Endocr Metab Immune Disord Drug Targets 2015; 15(3): 196-205.
[http://dx.doi.org/10.2174/1871530315666150316124019] [PMID: 25772174]
[76]
Pastor-Villaescusa B, Cañete MD, Caballero-Villarraso J, et al. Metformin for obesity in prepubertal and pubertal children: a randomized controlled trial. Pediatrics 2017; 140(1): e20164285.
[http://dx.doi.org/10.1542/peds.2016-4285] [PMID: 28759403]
[77]
Jing Y, Wu F, Li D, Yang L, Li Q, Li R. Metformin improves obesity-associated inflammation by altering macrophages polarization. Mol Cell Endocrinol 2018; 461: 256-64.
[http://dx.doi.org/10.1016/j.mce.2017.09.025] [PMID: 28935544]
[78]
Goldberg RB, Aroda VR, Bluemke DA, et al. Diabetes prevention program research group. Effect of long-term metformin and lifestyle in the diabetes prevention program and its outcome study on coronary artery calcium. Circulation 2017; 136(1): 52-64.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.025483] [PMID: 28476766]
[79]
Giagulli VA, Carbone MD, Ramunni MI, et al. Adding liraglutide to lifestyle changes, metformin and testosterone therapy boosts erectile function in diabetic obese men with overt hypogonadism. Andrology 2015; 3(6): 1094-103.
[http://dx.doi.org/10.1111/andr.12099] [PMID: 26447645]
[80]
Matsubara J, Sugiyama S, Sugamura K, et al. A dipeptidyl peptidase-4 inhibitor, des-fluoro-sitagliptin, improves endothelial function and reduces atherosclerotic lesion formation in apolipoprotein E-deficient mice. J Am Coll Cardiol 2012; 59(3): 265-76.
[http://dx.doi.org/10.1016/j.jacc.2011.07.053] [PMID: 22240132]
[81]
Assaly R, Gorny D, Compagnie S, et al. The favorable effect of empagliflozin on erectile function in an experimental model of type 2 diabetes. J Sex Med 2018; 15(9): 1224-34.
[http://dx.doi.org/10.1016/j.jsxm.2018.07.002] [PMID: 30145094]
[82]
Corona G, Fagioli G, Mannucci E, et al. Penile doppler ultrasound in patients with erectile dysfunction (ED): role of peak systolic velocity measured in the flaccid state in predicting arteriogenic ED and silent coronary artery disease. J Sex Med 2008; 5(11): 2623-34.
[http://dx.doi.org/10.1111/j.1743-6109.2008.00982.x] [PMID: 18783349]
[83]
Shao N, Yu X-Y, Yu Y-M, et al. Short-term combined treatment with exenatide and metformin is superior to glimepiride combined metformin in improvement of serum testosterone levels in type 2 diabetic patients with obesity. Andrologia 2018; 50(7): e13039.
[http://dx.doi.org/10.1111/and.13039] [PMID: 29740874]
[84]
Wing RR, Bond DS, Gendrano IN III, et al. Sexual Dysfunction Subgroup of the Look AHEAD Research Group. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study. Diabetes Care 2013; 36(10): 2937-44.
[http://dx.doi.org/10.2337/dc13-0315] [PMID: 23757437]
[85]
Shah M, Vella A. Effects of GLP-1 on appetite and weight. Rev Endocr Metab Disord 2014; 15(3): 181-7.
[http://dx.doi.org/10.1007/s11154-014-9289-5] [PMID: 24811133]

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