Erectile dysfunction

Erectile dysfunction is a common complication associated with diabetes of longer duration.

Oral phosphodiesterase type 5 (PDE5) inhibitors are first-line therapy although efficacy is lower in patients with diabetic autonomic neuropathy than in patients without. Nitrates interact with PDE5 inhibitors to produce a profound hypotensive response that may be fatal; avoid PDE5 inhibitors in patients taking nitrates.

Other treatments (eg intrapenile prostaglandin E₁ treatment, vacuum erection devices, penile prostheses) may be required if PDE5 inhibitors are ineffective or contraindicated. See Erectile dysfunction for management advice.