Sexual activity in diabetic patients treated by continuous subcutaneous insulin infusion therapy

Background and aimsAs concerns over interference with sexual activity may be an obstacle to initiating pump therapy in diabetic patients, the aim of the study was to assess the impact of continuous subcutaneous insulin infusion (CSII) therapy on sexual activity.Patients and methodsPatients filled out a questionnaire on their demographic data, diabetes history, pump-treatment history, metabolic control, inconvenience/convenience of the pump and catheter, and information on sexual activity.ResultsA total of 271 diabetic patients (aged 44 ± 17 years, 51% women, 22% single), treated with CSII for 4.2 ± 5.9 years and with a diabetes duration of 19 ± 11 years, filled out the questionnaire. Their HbA_1c was 7.7 ± 1.1%, with 2.4 ± 2.1 mild hypoglycaemic episodes over the past week, and their frequency of sexual activity was: never 29.9%; < 1/month 12.3%; > 1/month and < 1/week 18.2%; and > 1/week 39.6%. Age and cohabitation were independently correlated with frequency of sexual activity (P < 0.0001 and P < 0.0003, respectively), but not diabetes duration or complications. To the question “Does the pump have an influence on your sexual activity?”, The answer was “no” in 90% and “yes” in 10%. However, intercourse frequency was significantly decreased in the latter (P = 0.04). On multivariate analyses, this negative influence of CSII was correlated with HbA_1c (P < 0.05), discomfort with the pump (P < 0.05) and the number of mild hypoglycaemic episodes (P < 0.01).ConclusionFrequency of sexual activity appears to be unaffected by pump therapy or diabetes, but is decreased by the expected characteristics–namely, age and being single. Also, only 10% of patients believe that CSII is an obstacle during sexual activity and, in particular, because of the catheter.