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DIABETES AND FEMALE SEXUAL DYSFUNCTION

Women with diabetes are at increased risk for sexual arousal disorder—that is, inadequate vaginal and clitoral swelling in response to sexual arousal. A small research study showed that in women with type 1 diabetes, sildenafi l improved arousal, orgasm, and sexual enjoyment. A woman with diabetes should discuss problems of sexual arousal with her physician.

Summary

The symptoms of diabetes depend upon the degree of insulin defi ciency:

If the insulin defi ciency is modest so that the glucose levels are only slightly elevated, there may be no symptoms and diabetes may be discovered on routine testing.

If the insulin defi ciency is moderate, the presentation may be of bladder infection, vaginal or penile yeast infection, or increased nighttime urination.

If the insulin defi ciency is severe, there may be thirst, frequent urination, weight loss, tiredness, and blurred vision. If untreated there can be progression to diabetes ketoacidosis (in type 1 patients) or hyperosmolar coma (in type 2 patients).

People who have poor glucose control over many years are at risk of developing long-term complications. These include:

Diabetic eye disease—retinopathy, macular edema, cataracts, glaucoma. Untreated diabetic eye disease can lead to blindness.

Kidney failure, which if severe may lead to dialysis.

Neuropathy—peripheral neuropathy; autonomic neuropathy with resting fast heart rate and gastroparesis. Diabetic peripheral neuropathy increases the risk of foot injuries and infections. The nerve damage and circulatory problems of the penis can cause erectile dysfunction.

Circulatory problems: heart disease, strokes, impaired blood fl ow to the legs.

Treating blood glucose, lipids, and blood pressure can prevent the development and progression of these complications.



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