Tip 2 diyabetik kadınlarda cinsel fonksiyonların değerlendirilmesi
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Date
2012
Authors
Durgun, Onur
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Publisher
Uludağ Üniversitesi
Abstract
Diyabetes mellitusun cinsel fonksiyonları olumsuz etkilediği bilinmektedir. Özellikle diyabetin süresi, glisemik kontrol, yaş ve kullanılan farmakolojik tedavinin cinsel fonksiyon bozuklukları ile ilişkili olduğu bildirilmektedir. Literatürde bu tip çalışmaların daha çok erkekler üzerinde yapıldığı, kadınlarda ise buna oranla daha az olduğu görülmektedir. Son yıllarda, diyabetik kadınlardaki cinsel fonksiyon bozuklukları üzerinde çalışmalar artmaya başlamış ve bu konudaki bilgilerimiz çoğalmıştır.Biz de bu çalışmada tip 2 diyabetli kadınlarda cinsel fonksiyon bozukluğunun, yaş, diyabet yaşı, eğitim düzeyi, diyabetik komplikasyonlar, komorbid hastalıklar, glisemik kontrol ve aldıkları ilaç tedavisi gibi parametrelerle ilişkisini araştırmayı amaçladık.Çalışmaya 93 tip 2 diyabetes mellitus tanısı olan kadın dahil edildi. Kadınların cinsel fonksiyonlarını değerlendirmek için 19 soru içeren bir anket formu kullanıldı. Demografik bulgular, diyabetik komplikasyonlar, komorbid hastalıklar, A1c değerleri ve kullanmakta oldukları tedaviler ise düzenlediğimiz bir forma kaydedildi.Hastaların yaş ortalaması 48 ± 7.2 yıl, diyabet yaşı ortalaması 7.6 ± 6 yıl, A1c ortalaması 7.9 ± 1.9 gr/dl idi. Okur yazar olmayan 1 kişi (%1.1), ilkokul mezunu 46 kişi (%49.5), ortaokul mezunu 16 kişi (%17.2), lise mezunu 16 kişi (%17.2), üniversite mezunu 14 kişi (%15.1) vardı. İki hastada (%2.2) nefropati, yedi hastada (%7.5) retinopati, sekiz hastada (%8.6) nöropati, yedi hastada (%7.5) koroner arter hastalığı bulunmaktaydı. Kırk sekiz hastada (%51.6) hiperlipidemi, kırk yedi hastada (%50.5) hipertansiyon vardı. Kırk sekiz kişi (%51.6) oral antidiyabetik ilaçlarla (OAD), kırk beş kişi (%48.4) insülin ile tedavi görmekteyken 16 hasta (%17.2) beta bloker, 10 hasta (%10.8) antidepresan tedavisi almaktaydı.Hastaların %60.2'sinde cinsel istek bozukluğu, %52.7'sinde uyarılmada bozukluk, %55.9'unde ıslanmada bozukluk, %51.6'sınde orgazm bozukluğu, %58.1'inde tatminde bozukluk, %54.8'inde cinsel ilişki sırasında acı olması ve total skor olarak %55,9 hastada cinsel disfonksiyon saptandı.Yapılan istatistiksel değerlendirmede, hasta yaşı, diyabet yaşı, koroner arter hastalığı, hipertansiyon, nöropati, diyabetik tedavi ve antidepresan kullanımı gibi parametrelerle cinsel fonksiyon bozukluğu arasında anlamlı ilişki saptanırken, retinopati, glisemik kontrol, eğitim düzeyi, hiperlipidemi ve beta bloker kullanımı arasında anlamlı ilişki saptanmadı.Çalışmamızda, diyabetik kadınlarda, diyabet yaşı, hipertansiyon, koroner arter hastalığı, nöropati ve kullandıkları tedavi gibi etkenlerin cinsel disfonksiyon için risk faktörü olabileceği sonucuna varılmıştır. Bu yöndeki çalışmaların sosyal faktörler nedeniyle yapılmasının zor olması, çalışmanın yapılabilirliğini ve genişliğini etkilemektedir. Toplumun, diyabetin cinsel fonksiyonlar üzerine etkisi konusunda eğitilmesi ve bilinçlendirilmesi ile daha geniş hasta gruplarına ulaşarak daha kapsamlı verilerin elde edilebileceği kanısındayız.
It is known that diabetes mellitus has advers effects on sexual functions. Especially duration of diabetes, glycemic control, age and pharmacologic treatment are introduced to have effects on sexual function disorders. In literature these kind of studies are mostly done on males while studies on females are relatively low. Recently, studies about sexual function dysorders on diabetic women and our knowledge about this topic have increased.In this study we planned to evaluate the relationship between sexual functions and age, duration of diabetes, education level, diabetes complications, comorbid conditions, glycemic control and oral antidiabetic agent or insulin usage of women of type 2 diabetes.93 women who have type 2 diabetes mellitus were included in the study. A questionnaire (FSFI) of 19 questions was used to evaluate sexual functions of women. Demographic findings, diabetic complications, comorbid conditions, A1c value and treatments taken were recorded in a separate file.The mean age of patients was 48 ±7,2 years, mean diabetes duration was 7,6 ±6 years and the mean A1c value was 7.9 ±1.9 g/dl. 14 patients (15.1%) have university degree, 16 patients (17.2%) have high school degree, 16 patients (17.2%) have middle school degree, 47 patients (49%) have primary school degree and 1 (1.1%) patient doesn?t have a degree at all. There was nephropathy in 2 (2,2%) patients, retinopathy in 7 (7,5%) patients, neuropathy in 8 (8,6%) patients, coronary artery disease in 7 (7,5%) patients. There was hyperlipidemia in 48 (51.6%) patients and hypertension in 47 (50.5%) patients. 48 (51.6%) patients were treated with oral antidiabetic agents whereas 45 (48.4%) of them were treated with insulin. There was 16 (17.2%) patients taking beta blocker and 10 (10.8%) patients taking antidepressant medication.The prevalance of desire disoder was 60.2%, aurosal disorder was 52.7%, lubrication disorder was 55.9%, orgasmic diysfunction was 51.6%, satisfaction disorder was 58.1% and pain with sexual intercourse was 54.8%. Considering the total FSFI score, 55.9% of patients had sexual dysfunction.There was statistically significant correlation between sexual function disorder and parameters like patient?s age, duration of diabetes, precense of coronary artery disease, precense of hypertension, precense of neuropathy, treatment type for diabetes and antidepressant medications. However, no significant correlation was detected between sexual function disorder and retinopathy, glisemic control, education level, precense of hyperlipidemia and beta blocker medications.Finally, considering the data in this study, longer duration of diabetes, precense of hypertension, precense of diabetic neuropathy, coronary artery disease and insulin treatment can be stated as risk factors for sexual dysfunction in diabetic women. Difficulties arising from social factors in these studies effect the feasibility and the size of the study. We believe that with public education and awareness on effects of diabetes on sexual functions, we can reach to a lot more patients and collect more detailed data.
It is known that diabetes mellitus has advers effects on sexual functions. Especially duration of diabetes, glycemic control, age and pharmacologic treatment are introduced to have effects on sexual function disorders. In literature these kind of studies are mostly done on males while studies on females are relatively low. Recently, studies about sexual function dysorders on diabetic women and our knowledge about this topic have increased.In this study we planned to evaluate the relationship between sexual functions and age, duration of diabetes, education level, diabetes complications, comorbid conditions, glycemic control and oral antidiabetic agent or insulin usage of women of type 2 diabetes.93 women who have type 2 diabetes mellitus were included in the study. A questionnaire (FSFI) of 19 questions was used to evaluate sexual functions of women. Demographic findings, diabetic complications, comorbid conditions, A1c value and treatments taken were recorded in a separate file.The mean age of patients was 48 ±7,2 years, mean diabetes duration was 7,6 ±6 years and the mean A1c value was 7.9 ±1.9 g/dl. 14 patients (15.1%) have university degree, 16 patients (17.2%) have high school degree, 16 patients (17.2%) have middle school degree, 47 patients (49%) have primary school degree and 1 (1.1%) patient doesn?t have a degree at all. There was nephropathy in 2 (2,2%) patients, retinopathy in 7 (7,5%) patients, neuropathy in 8 (8,6%) patients, coronary artery disease in 7 (7,5%) patients. There was hyperlipidemia in 48 (51.6%) patients and hypertension in 47 (50.5%) patients. 48 (51.6%) patients were treated with oral antidiabetic agents whereas 45 (48.4%) of them were treated with insulin. There was 16 (17.2%) patients taking beta blocker and 10 (10.8%) patients taking antidepressant medication.The prevalance of desire disoder was 60.2%, aurosal disorder was 52.7%, lubrication disorder was 55.9%, orgasmic diysfunction was 51.6%, satisfaction disorder was 58.1% and pain with sexual intercourse was 54.8%. Considering the total FSFI score, 55.9% of patients had sexual dysfunction.There was statistically significant correlation between sexual function disorder and parameters like patient?s age, duration of diabetes, precense of coronary artery disease, precense of hypertension, precense of neuropathy, treatment type for diabetes and antidepressant medications. However, no significant correlation was detected between sexual function disorder and retinopathy, glisemic control, education level, precense of hyperlipidemia and beta blocker medications.Finally, considering the data in this study, longer duration of diabetes, precense of hypertension, precense of diabetic neuropathy, coronary artery disease and insulin treatment can be stated as risk factors for sexual dysfunction in diabetic women. Difficulties arising from social factors in these studies effect the feasibility and the size of the study. We believe that with public education and awareness on effects of diabetes on sexual functions, we can reach to a lot more patients and collect more detailed data.
Description
Keywords
Diyabetes mellitus, Diyabetik komplikasyonlar, Glisemik kontrol, Cinsel fonksiyon bozukluğu, Farmakolojik tedavi, Diabetic complications, Glysemic control, Sexual function disorder, Pharmacologic medications
Citation
Durgun, O. (2012). Tip 2 diyabetik kadınlarda cinsel fonksiyonların değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.