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"This effect was more significant among middle-aged men 40 to 59 years old," said lead researcher Dr. Sean Skeldon, a resident in family medicine at the University of Toronto in Canada.
The report was published in the July/August issue of the Annals of Family Medicine.
For the study, Skeldon's team collected data on more than 4,500 men 20 and older who took part in the U.S. National Health and Nutrition Examination Survey from 2001 to 2004.
But they found that the prevalence of undiagnosed diabetes was 11.5 percent in men with impotence compared to about 3 percent among men without the disorder. In men aged 40 to 59, the rate of undiagnosed diabetes was 19 percent in men with erectile dysfunction compared to 3 percent in those who didn't have erectile troubles, the study found.
Erectile dysfunction is a risk factor for future heart disease, Skeldon said. Unlike diabetes, high blood pressure or high cholesterol, which typically have no obvious symptoms, impotence is something men recognize as a problem, he said.
"Men with erectile dysfunction should see their doctors to ensure they are properly screened for diabetes," Skeldon said. "Doing so may help prevent heart disease down the road. Conversely, doctors should ensure that they perform the proper screening for men with erectile dysfunction."
Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said, "Usually, erectile dysfunction is not an early complication of diabetes -- it's a late complication caused by changes in nerve function."
These findings indicate that men with erectile dysfunction may have had undiagnosed diabetes for an extended time, he added.
However, men with impotence who are at an early stage of diabetes may have another medical problem having nothing to do with their diabetes that led to the erectile dysfunction, Zonszein said.
Zonszein said doctors are often lax in asking their patients about their sexual health. "In clinical practice we don't get a good history of erectile dysfunction," he said.
Doctors should get a history of sexual function, because erectile dysfunction can be a sign of undiagnosed diabetes, Zonszein explained.
"Diabetes is not a benign disease," he said. "We have to make the diagnosis early and we have to treat diabetes early and aggressively."
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