We assessed the prevalence and risk factors of erectile dysfunction (ED) in men with type 2 diabetes (T2DM) compared with men without diabetes in Catalonia, Spain.
This cross-sectional study used routinely collected primary care data from the SIDIAP database (covering ∼80% of the Catalan population) from 1st January 2010-30 th June 2023. Men ≥ 18 years with at least one primary care visit and one recorded laboratory test were included. T2DM was identified through ICD-10 codes, antidiabetic drugs, or HbA1c ≥ 6.5%; men without diabetes had no recorded diagnosis or criteria for any diabetes. ED was defined by ICD-10 codes (F52, N48.9) and/or prescriptions for approved ED treatments. Sociodemographic, lifestyle, clinical and laboratory data, comorbidities and medications were extracted. Multivariable logistic regression assessed factors associated with ED.
Among 659,501 men (177,380 with T2DM; 492,121 without), overall ED prevalence was 9.5%. Prevalence was 1.5-fold higher in T2DM (12.6%) than in men without diabetes (8.3%), peaking at 55-64 years. Older age, longer diabetes duration, poorer glycaemic control, smoking, high-risk alcohol use, hypertension, dyslipidaemia, cardiovascular and microvascular disease, obesity and depression were independently associated with ED.
Men with T2DM show markedly higher ED prevalence and multiple cardiometabolic risk factors. ED remains under-recognised and should be systematically assessed in primary care as both a complication and a clinical marker of cardiometabolic risk.
Primary care diabetes. 2026 Apr 17 [Epub ahead of print]
Santiago Martínez-Mores, Maria Belén Vilanova Fillat, Bogdan Vlacho, Elena Navas, Berta Fernandez-Camins, Josep Franch-Nadal, Dídac Mauricio
Department of Endocrinology & Nutrition, IR SANT PAU, Hospital de la Santa Creu i Sant Pau Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, Barcelona 08041, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain., Primary Care Centre Igualada Nord, Igualada, Spain; DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain., DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain. Electronic address: ., DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain., Department of Endocrinology & Nutrition, IR SANT PAU, Hospital de la Santa Creu i Sant Pau Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, Barcelona 08041, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain., Department of Medicine, University of Barcelona, Barcelona, Spain; DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain. Electronic address: ., Department of Endocrinology & Nutrition, IR SANT PAU, Hospital de la Santa Creu i Sant Pau Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, Barcelona 08041, Spain; DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Spain; Faculty of Medicine, University of Vic/Central University of Catalonia (UVIC/UCC), Vic, Spain.