Importance of assessing erectile dysfunction in patients with type 2 diabetes mellitus based on glucose fluctuation: a Cross-Sectional study

Purpose To investigate the relationship between glucose fluctuation and erectile dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM). Methods This cross-sectional study included 317 male patients with T2DM. Participants were categorized into non-ED group (76 cases) and ED group (241 cases) based on International Index of Erectile Function-5 (IIEF-5) scores. Patients were additionally segmented into quartiles based on time in range (TIR). Demographic and laboratory data were collected, and glucose fluctuation indicators were ascertained using flash glucose monitoring. Results The ED group exhibited significantly lower TIR and IIEF-5 scores compared to the non-ED group (P < 0.05). An increase in TIR levels corresponded with higher IIEF-5 scores and a significant reduction in ED incidence (P < 0.05). Spearman's correlation analysis indicated a positive correlation between IIEF-5 scores and TIR (r = 0.48, P < 0.01). Restricted cubic spline analysis revealed a negative linear association between TIR and ED (P for linearity <0.05). Multivariate logistic regression analysis, after adjusting for confounding factors, confirmed that low TIR is an independent risk factor for ED (P < 0.05). Conclusion Glucose fluctuation in T2DM patients correlate with ED, with low TIR being independently and positively associated with ED incidence, suggesting it may be a significant risk factor for ED in patients with T2DM.