Love in the Time of Diabetes

candy-heartA diagnosis of diabetes brings with it a plethora of lifestyle changes. Patients must switch up their diet and exercise habits, take on a new routine of daily medications and injections, and keep an eye on their blood sugar. But another potential change under the cloud of diabetes is even more personal: the diabetic’s sex life. With diabetes rates on the rise, and the lifespan of those with diabetes gradually lengthening, it would be informative for doctors to know how often their older, diabetic patients are having intimate moments and whether the disease impacts their sexual health.

In an article published last week in the journal Diabetes Care, a team led by Stacy Tessler Lindau at the University of Chicago Medical Center shed light on the previously hidden sex lives of elderly diabetics. With a dataset of interviews with older adults – in fact, the same dataset used for the medication disparities study ScienceLife wrote about last week – the researchers were able to analyze the sexual health and un-health of people with diagnosed and undiagnosed diabetes. The results found that diabetes doesn’t take as big a bite out of a person’s sex life as might be expected – though all is not entirely well.

“Patients and doctors need to know that most middle age and older adults with partners are still sexually active despite their diabetes,” said Lindau, an associate professor of obstetrics and gynecology. “However, many people with diabetes have sexual problems that are not being addressed.”

When it comes to elderly diabetics who are married or living with a partner, the numbers on who remains sexually active are in line with the general population. Broken down by gender, the same sexual gap appears with diabetics as well – diabetic men between the age 0f 57 and 85 are more than twice as likely to be sexually active as diabetic women of the same age. A similar imbalance was seen for the discussion of sexual issues with a physician: 46.8 percent of men said they had talked with a doctor about the topic, compared to only 18.8 percent of women.

“Failure to recognize and address sexual issues among middle-age and older adults with diabetes may impair quality of life and adaptation to the disease,” said Marshall Chin, senior author of the study and professor of medicine. “Sexual problems are common in patients with diabetes, and many patients are not discussing these issues with their physicians.”

Those sexual problems included erectile dysfunction, loss of sexual interest, and issues with orgasm, all of which were elevated in diabetic individuals compared to those without diabetes. Subdividing the diabetic group further into those with diagnosed and undiagnosed diabetes allowed for an interesting comparison of whether those sexual problems are physiological or psychological. Men who were aware of their diabetes were more likely than undiagnosed men to have erectile dysfunction and loss of sexual interest, suggesting a psychological component to their problems, the authors proposed.

“Ignorance of the diagnosis protects individuals from the psychological burden and stigma associated with having diabetes,” said Lindau. “The elevated prevalence of orgasm difficulties in people unaware of their diabetes suggests that these are predominantly physical. The erectile dysfunction and loss of interest among men with a diagnosis may be due in part to the psychological burden of diabetes.”

The third sexual symptom – difficulty in reaching orgasm – was similar for those with diagnosed and undiagnosed diabetes, suggesting that this particular sexual issue could actually be an early warning sign for the disease. But the tip-off would only be useful if doctors discussed such symptoms with their patients, something that is far less common than discussions of erectile dysfunction, the authors report. Openly talking about sex might be one of the more difficult lifestyle changes for an older patient with diabetes, but it could have dramatic benefits for the quality of that readjusted life.

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Lindau, S., Tang, H., Gomero, A., Vable, A., Huang, E., Drum, M., Qato, D., & Chin, M. (2010). Sexuality Among Middle Age and Older Adults with Diagnosed and Undiagnosed Diabetes: A National, Population-Based Study Diabetes Care DOI: 10.2337/dc10-0524

About Rob Mitchum (518 Articles)
Rob Mitchum is communications manager at the Computation Institute, a joint initiative between The University of Chicago and Argonne National Laboratory.

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