Pharmacotherapeutic strategies for the management of erectile dysfunction in patients with diabetes and pre-diabetes.

Autor:	Corona G; Endocrinology Unit, AUSL Bologna, Maggiore Hospital, Bologna, Italy., Rastrelli G; Andrology, Women's Endocrinology and Gender Incongruence Unit, Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy., Sparano C; Endocrinology Unit, Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy., Vignozzi L; Andrology, Women's Endocrinology and Gender Incongruence Unit, Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy., Sforza A; Endocrinology Unit, AUSL Bologna, Maggiore Hospital, Bologna, Italy., Maggi M; Endocrinology Unit, Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Jazyk:	angličtina
Zdroj:	Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2024 Nov; Vol. 25 (16), pp. 2213-2223. Date of Electronic Publication: 2024 Nov 05.
DOI:	10.1080/14656566.2024.2422547
Abstrakt:	Introduction: Erectile dysfunction (ED) is a neglected complication in patients with pre-diabetes or diabetes mellitus (DM). Areas Covered: A summary and review of the role of standard ED treatment and the contribution of lifestyle modification and hypoglycemic drugs. Expert Opinion: Oral phosphodiesterase type 5 inhibitors (PDE5i) represent the first-line therapy even in patients with DM. Testosterone replacement therapy (TRT) is mandatory in all hypogonadal (total testosterone < 12 nmol/l) subjects. Alprostadil and/or combined approaches can be considered when PED5i with or without TRT fail. The glycometabolic optimization through lifestyle modification and the use of hypoglycemic drugs represents a crucial step, even for ED treatment. Considering the strong association between ED and forthcoming cardiovascular diseases, the selection of glucagon-like peptide type 1 analogues or sodium glucose cotransporter-2 inhibitors seems to represent the best option due to their long-term effect on chronic complication prevention. Metformin can be considered a possible alternative in less complicated subjects. Penile prostheses (PP) can be offered when all other options are not effective, but the patients should be informed that poor glycometabolic control can increase the risk of PP infection.
Databáze:	MEDLINE
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