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    Diabetes mellitus ist eine chronische Stoffwechselerkrankung, die durch einen erhöhten Blutzuckerspiegel (Hyperglykämie) gekennzeichnet ist. Ursache ist entweder ein Insulinmangel, eine Insulinunempfindlichkeit (Insulinresistenz) oder beides. Diabetes mellitus kommt hauptsächlich in zwei Formen vor: Typ-1-Diabetes entsteht durch einen Mangel am Hormon Insulin. Körpereigene Abwehrstoffe (Antikörper) zerstören die Insulin produzierenden Zellen der Bauchspeicheldrüse. Diese Form beginnt meist schon im Kindes- oder Jugendalter. Typ-2-Diabetes entsteht zum einen durch eine verminderte Empfindlichkeit der Körperzellen für Insulin (Insulinresistenz). Zum anderen führt eine jahrelange Überproduktion von Insulin zu einer "Erschöpfung" der Insulin produzierenden Zellen. Erectile dysfunction is a common occurrence in men with diabetes. The incidence of erectile dysfunction increases progressively with age, from 5% in men age 20 to 75% in men over age 65. The cause of erectile dysfunction in men with diabetes is usually related to a decrease in the blood supply to the penis as well as to injury to the nerves that are responsible for the erection mechanism. A decrease in testosterone production has also been identified as the cause in some men with diabetes. Since 1998, when sildenafil (brand name Viagra) first came on the market, oral therapy has been successfully used to treat erectile dysfunction in many men with diabetes. (Sildenafil was followed in 2003 by the drugs tadalafil [Cialis], vardenafil [Levitra] and avanafil [Stendra], which work in much the same way.) Some 50% of men with Type 1 diabetes who try the drugs report improved erections, and some 60% men with Type 2 diabetes do, too. However, that leaves a large percentage of men with diabetes and erectile dysfunction who do not respond to therapy with one of these pills.

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