Anti-diabetic Medication Use, Glycaemic Control and Sexual Function: A Cross Sectional Study Among Men with Type-2 Diabetes Mellitus in Nigeria
Authors
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
Introduction: Drug utilization studies are usually aimed at promoting rational use of medicines, improving therapeutic outcomes and enhancing patients’ quality of life. Studies on anti-diabetic drugs generally focus on the pattern of prescription and use without necessary assessing the association between drug use and glycemic control. Objectives: This study was aimed at evaluating the association between anti-diabetic medication use, glycemic control and sexual function in men with type-2 diabetes mellitus. Materials and Methods: It was cross sectional, descriptive, hospital-based study conducted among persons with type 2 diabetes mellitus receiving care at two selected healthcare facilities in Nigeria. Data on the socio-demographic details of the participants was collected using a semi-structured questionnaire. The clinical, biochemical and anthropometric characteristics of the patients were also obtained. Furthermore, data on sexual function was obtained using the International Index of Erectile Function Questionnaire (IIEF). Data on the prescribed antidiabetic drugs were obtained and reviewed. Data analysis was carried out using the IBM SPSS programme. Descriptive and inferential statistics were used as applicable with p < 0.05 considered statistically significant. Results: A total of 213 male patients with type-2 diabetes mellitus were recruited into the study. About 71.8% (n = 153) of the participants were identified as having sexual dysfunction (SD). Erectile dysfunction was the most frequently reported form of sexual dysfunction [97.4% (95% CI = 93.4 - 99.3%)]. Fasting blood sugar (χ2 = 4.73; p = 0.03) and glycosylated hemoglobin (χ2 = 5.13; p = 0.04) were significantly associated with the presence sexual dysfunction among the patients. The biguanides (36.67%; n = 510) were the most frequently prescribed class of antidiabetic drug. Only pioglitazone was significantly associated with glycemic control [OR (95% CI) = 0.40(0.19-0.85); p = 0.02]. There was no statistically significant association (p > 0.05) between the prescribed antidiabetic drugs and the occurrence of sexual dysfunction. Conclusion: The occurrence of sexual dysfunction was high in the patient population studied. It was significantly associated with the level of glycemic control. There was no statistically significant association between antidiabetic drug use and the occurrence of sexual dysfunction in this patient population.
##plugins.themes.bootstrap3.article.details##
Copyright (c) 2025 Unwana Osom, Unyime Eshiet, Paul Nwafor
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Unwana Osom, Directorate of Health Services, University of Uyo, Uyo, Nigeria.
Directorate of Health Services, University of Uyo, Uyo, Nigeria.
Unyime Eshiet, Department of Clinical Pharmacy & Biopharmacy, University of Uyo, Uyo, Nigeria.
Department of Clinical Pharmacy & Biopharmacy, University of Uyo, Uyo, Nigeria.
Paul Nwafor, Department of Pharmacology and Therapeutics, Rivers State University, Port Harcourt, Nigeria.
Department of Pharmacology and Therapeutics, Rivers State University, Port Harcourt, Nigeria.
[1] Okoro, R.N., Nmeka, C. and Erah, P.O. (2017). Utilization study of anti-diabetes medicines in tertiary care hospital in Nigeria. Future Journal of Pharmaceutical Services, 1-7.
[2] Stratton, I. M., Adler, A. I., and Neil, H. A. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS-35): prospective observational study. British Medical Journal, (7258): 405-412.
[3] Rana, B., Bukhsh, A., Khan, T.M., Sarwar, A., Omer, M.O., Jamshed, S.Q. (2017). Evaluation of therapeutic effectiveness of prescribed medications in patients with type 2 diabetes mellitus: findings from tertiary care hospital, Lahore Pakistan. Journal of Pharmacy and Bio-allied Sciences, 9 (2): 121-125.
[4] United Kingdom Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type diabetes (UKPDS 33). Lancet, 353 (9131): 837-53.
[5] World Health Organization (WHO), (2003). Introduction to drug utilization research/statistics methodology, WHO collaborating center for drugs statistics methodology, centre for drugs utilization and research and clinical pharmacological services.
[6] Patel, B., Oza, B., Patel, K. P., Malhotra, S. D., Patel, V. J. (2013). Pattern of anti-diabetic drugs use in type-2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital. International Journal of Basic and Clinical Pharmacology, 2 (4): 485-491.
[7] Agarwal, A.A., Jadhav, P.R.. and Deshmukh, Y.A. (2014). Prescribing pattern and Efficacy of anti-diabetic drugs in maintaining optimal glycaemic levels in diabetic patients. Journal of Basic and Clinical Pharmacy, 5(3):79-83.
[8] Ahmed, Z., Hafzer, M. A., Bari, M. A., Akhter, J. (2016). Pattern of anti-diabetic drugs prescribed in a tertiary care hospital in Bangladesh. International Journal of Basic Clinical Pharmacology, 5 (1): 6-12.
[9] Uwakwe JN, Agboghoroma OF, Akanbi FO, Odoh G, Puepet FH. Pattern of anti diabetic drug prescription at a health facility in Jos, North-Central Nigeria. Jos Journal of Medicine. 9(1):59–62.
[10] Usman, H.M., Medinat, K.O., and Rashida, A. (2014). Medication adherence evaluation among diabetic patients attending a secondary health facility in northern Nigeria. International Journal of Pharmacy teaching and Practices, 5(4):1561-1565.
[11] Ogbonna, B.O., Ezenduka, C.C., Opara, C.A., Ahara, L.G. (2014). Drug therapy problems in patients with type 2 diabetes in a tertiary hospital in Nigeria. International Journal of Innovative Research and Development, 3(1): 494-502.
[12] Olurishe, C.O., Gyang, S.O., Olurishe, T.O., Shekarau, T.T. (2012). Drug utilization review of anti-diabetic medications and therapeutic outcome in type 2 diabetes in a tertiary hospital in northern Nigeria.West African Journal of Pharmacy, 23 (2): 58-64.
[13] Araoye, M.O. (2004) Sample Size Determination in Research Methodology with Statistics for Health and Social Sciences. Nathadex Publishers, Ilorin, 115-121.
[14] Unadike, B. C., Eregie, A. and Ohwovoriole, A. E., (2008). Prevalence and types of sexual dysfunction among males with diabetes mellitus in Nigeria. Mera Diabetes International 18-20.
[15] Rosen, R. C., Riley, A., Wagner, G., Osterioh, I.H., KirkPatrick, J., Mishra, A. (1997). The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction, Urology, 6:822-830.
[16] Haghighat Panah, M., Thunga G., Jha, A., Mallayasamy, S. (2016). Study on prescribing pattern of anti-diabetic drugs among type 2 diabetes patients with complications in south Indian Teaching Hospital. Asian Journal of Pharmaceutical and Clinical Research, 9(1): 194-197.
[17] Alkhaja, K.A., Sequeira, R.P. and Mathur, V.S. (2001). Prescribing patterns and therapeutic implications for diabetic hypertension in Bharain. Annals of Pharmacotherapy. 35: 1350-1359.
[18] Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Shah K. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. J Clin Diag Res. 2007;1:248–55.
[19] George, C. M., Bruun, L. L., Will, K., Howard-Thompson, A. (2015). Non-insulin therapies for type 2 diabetes. American Association of Family Physicians, 92(1): 100-112.
[20] Khardori, R. (2017). Type 2 Diabetes mellitus treatment and management. Drugs and diseases-Endocrinology e-Medicine Medscape.com
[21] Qaseem, A., Barry, M. J., Humphrey, L. L., Forciea, M. A. (2017). Clinical guidelines committee of the American College of Physicians. Oral pharmacological treatment of type 2 diabetes mellitus: a clinical practice guideline update from the American college of physician. American journal of Internal Medicine, 100: 207-220.
[22] Satpathy, S.V., Datta, S. and Upreti, B. (2016). Utilization study of anti-diabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines. Journal of Pharmacy and Bio-allied Sciences, 8(3): 223-238.
[23] Acharya, K.G., Shah, K.N., Solanki, N.O., Rana, D.A. (2013). Evaluation of anti-diabetic prescription, cost and adherence to treatment guidelines: a prospective, cross sectional study at a tertiary care teaching hospital. Journal of Basic Clinical Pharmacy, 3: 82-87.
[24] Feng L, Jinhua W, Shulin G, Jiangping X, Zhongxiang L and Xiaohong L (2024) Causal association between antidiabetic drugs and erectile dysfunction: evidence from Mendelian randomization. Front. Endocrinol. 15:1414958. doi: 10.3389/fendo.2024.1414958
[25] Rey-Valzacchi GJ, Costanzo PR, Finger LA, Layus AO, Gueglio GM, Litwek LE et.al. Addition of Metformin to Sildenafil treatment for erectile dysfunction in eugonodal non-diabetic men with insulin resistance. A prospective, randomized, double-blind pilot study. JAndrol. (2012) 33 (4):608-14. Doi: 10.2164/jandrol.111.013714.
[26] Al-Kuraishy HM, Al-Gareeb AI. Erectile dysfunctionand low sex drive in men with type 2 DM: the potential role of diabetic pharmacotherapy. J Clin Diagn Research: JCDR (2016) 10: FC21-6. Doi: 10.7860/JCDR/2-16/19971.8996.
[27] Abul-Hadi MH, Naji MT, Shams HA, Sami OM, Al-Kuraishy HM, Al-Garreb AI. Erectile dysfunction and type 2 diabetes mellitus: A new twist. Int J Nutrition Pharmacology Neurological Dis (2020) 10:43-9. Doi:10.4103/ijnpnd.ijnpnd_83_19.
[28] Insuk SO, Chae MR, Choi JW, Yang DK, Sim JH, Lee SW. Molecular basis and characteristics of KATP channel in human corporal smooth muscle cells. Int J Impotence Res (2003) 15:258-66. Doi: 10.1038/sj.ijir.3901013.
[29] Yki-Järvinen H. Thiazolidinediones. N Engl J Med. 2004 Sep 9;351(11):1106-18. doi: 10.1056/NEJMra041001. PMID: 15356308
[30] Phung, O.J., Sood, N.A., Sill, B.E., Coleman, C.L. (2011). Oral anti-diabetic drugs for the prevention of type 2 diabetes. Diabetic Medicines, 8: 948-964.