Background Erectile dysfunction (ED) is frequently undiagnosed in males with type 2 diabetes mellitus (T2DM), despite its high prevalence. Early detection of ED in T2DM is crucial for effective treatment and prevention of severe complications such as cardiovascular events. This study explores the prevalence of ED and its associated factors in males with and without T2DM at Livingstone University Teaching Hospital (LUTH), Zambia.

Methodology We conducted a cross-sectional study at LUTH among 42 males aged ≥18 years (22 with and 20 without T2DM). T2DM diagnosis was confirmed through medical records, and erectile dysfunction was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. Logistic regression identified factors associated with ED, with significance set at a p-value less than 0.05

Results The overall prevalence of ED was 74% (31/42). Among T2DM participants, the prevalence of ED was 91% (20/22; 95% confidence interval (CI) 70.8-98.9) whereas among the non-diabetic participants, the prevalence was 55% (11/20; 95%CI 31.5-76.9). The majority [40% (8/20)] of the T2DM participants with ED had mild ED, 35% (7/20) had mild to moderate ED, 15% (3/20) had moderate ED and 10% (2/20) had severe ED. 54.5% (6/11)] of the non-T2DM participants with ED had mild ED, 36.4% (4/11) had mild to moderate ED, 9.1% (1/11) had moderate ED, and none had severe ED. In the multivariable analysis, employed individuals had lower odds of erectile dysfunction compared to the unemployed (OR 0.01, 95% CI 0.00 - 0.84, p = 0.041); while elevated plasma creatinine levels were associated with an increased risk of erectile dysfunction (OR 1.22, 95% CI 1.03 - 1.45, p = 0.021).

Conclusion This study underscores a significant prevalence of ED, particularly heightened in T2DM participants; and significantly associated with plasma creatinine levels and employment status. The findings highlight the need for comprehensive assessment and management of ED in T2DM individuals. There is a need for further research with larger sample sizes to validate the findings and for a clearer understanding of associated factors and identification of effective targeted interventions.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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Ethical approval was obtained from the Mulungushi University School of Medicine and Health Sciences Research Ethics Committee (SMHS-MU1-2023-24, dated 6th March 2023).

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