{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:58:49Z","timestamp":1785437929524,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMGH-113R008"],"award-info":[{"award-number":["KMGH-113R008"]}]},{"award":["KMGH-113R008"],"award-info":[{"award-number":["KMGH-113R008"]}],"id":[{"id":"https:\/\/ror.org\/03gk81f96","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background\/Objectives: Erectile dysfunction (ED) affects up to 50% of men with type 2 diabetes mellitus (T2DM), yet the independent effects of oral antihyperglycemic medications on erectile function remain controversial. This study investigated associations between commonly prescribed antihyperglycemic medications and erectile function in Taiwanese men with T2DM. Methods: This cross-sectional study enrolled 242 Taiwanese men aged 18\u201380 years with T2DM. Erectile function was assessed using the International Index of Erectile Function\u20135 (IIEF-5). Participants were categorized by 12-month HbA1c patterns into well-controlled, variably controlled, and poorly controlled groups. Multiple linear regression models adjusted for demographics, metabolic parameters, and comorbidities examined medication\u2013IIEF-5 associations. Results: The mean IIEF-5 score was 18.16 \u00b1 5.68. None of the seven oral antihyperglycemic medication classes showed significant independent associations with IIEF-5 scores. However, glycemic control demonstrated a significant association with erectile function (F(2,192) = 3.390, p = 0.036), with well-controlled patients showing higher scores than poorly controlled patients (mean difference = 2.488, p = 0.032). Conclusions: In this cross-sectional study, better glycemic control was associated with improved erectile function in men with T2DM. No significant independent associations were observed between individual oral antihyperglycemic medication classes and erectile function after adjustment for glycemic control and other confounders. These findings suggest that glycemic management, rather than the independent effect of medication class, may be the primary determinant of erectile function in this population; however, causal inferences cannot be drawn from this cross-sectional design.<\/jats:p>","DOI":"10.3390\/life16040597","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:10:27Z","timestamp":1775448627000},"page":"597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Oral Antihyperglycemic Medications and Erectile Function in Men with Type 2 Diabetes Mellitus"],"prefix":"10.3390","volume":"16","author":[{"given":"Chia-Hao","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-2607","authenticated-orcid":false,"given":"Ming-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7318-5152","authenticated-orcid":false,"given":"Tzu-Jung","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"},{"name":"Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"},{"name":"School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Yueh","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan"},{"name":"School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan"},{"name":"Department of Internal Medicine, Kaohsiung Medical University Gangshan Hospital, Kaohsiung 820111, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e3494","DOI":"10.1002\/dmrr.3494","article-title":"Erectile dysfunction and diabetes: A melting pot of circumstances and treatments","volume":"38","author":"Defeudis","year":"2022","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1111\/dme.13403","article-title":"High prevalence of erectile dysfunction in diabetes: A systematic review and meta-analysis of 145 studies","volume":"34","author":"Kouidrat","year":"2017","journal-title":"Diabet. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1007\/s40618-022-01788-5","article-title":"Erectile dysfunction as a marker of endocrine and glycemic disorders","volume":"45","author":"Mazzilli","year":"2022","journal-title":"J. Endocrinol. Investig."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Maruhashi, T., and Higashi, Y. (2021). Pathophysiological Association between Diabetes Mellitus and Endothelial Dysfunction. Antioxidants, 10.","DOI":"10.3390\/antiox10081306"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"13052","DOI":"10.3892\/mmr.2023.13052","article-title":"Pyroptosis and inflammation-mediated endothelial dysfunction may act as key factors in the development of erectile dysfunction (Review)","volume":"28","author":"Zhu","year":"2023","journal-title":"Mol. Med. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1111\/j.1743-6109.2010.01778.x","article-title":"Definitions\/epidemiology\/risk factors for sexual dysfunction","volume":"7","author":"Lewis","year":"2010","journal-title":"J. Sex. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.genm.2008.12.003","article-title":"Diabetes, obesity, and erectile dysfunction","volume":"6","author":"Tamler","year":"2009","journal-title":"Gend. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/andr.13192","article-title":"Effects of diet and antihyperglycemic drugs on erectile dysfunction: A systematic review","volume":"11","author":"Defeudis","year":"2023","journal-title":"Andrology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Feng, L., Jinhua, W., Shulin, G., Jiangping, X., Zhongxiang, L., and Xiaohong, L. (2024). Causal association between antidiabetic drugs and erectile dysfunction: Evidence from Mendelian randomization. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1414958"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"467","DOI":"10.2147\/DMSO.S503216","article-title":"Effects of Anti-Diabetic Drugs on Erectile Dysfunction: A Systematic Review and Meta-Analysis","volume":"18","author":"Yang","year":"2025","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1038\/s41443-024-00895-6","article-title":"Prescribing semaglutide for weight loss in non-diabetic, obese patients is associated with an increased risk of erectile dysfunction: A TriNetX database study","volume":"37","author":"Able","year":"2025","journal-title":"Int. J. Impot. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/andr.13519","article-title":"Long-acting glucagon-like peptide 1 receptor agonists boost erectile function in men with type 2 diabetes mellitus complaining of erectile dysfunction: A retrospective cohort study","volume":"12","author":"Lisco","year":"2024","journal-title":"Andrology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/sj.ijir.3900472","article-title":"Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction","volume":"11","author":"Rosen","year":"1999","journal-title":"Int. J. Impot. Res."},{"key":"ref_14","first-page":"FC21","article-title":"Erectile Dysfunction and Low Sex Drive in Men with Type 2 DM: The Potential Role of Diabetic Pharmacotherapy","volume":"10","year":"2016","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"22","DOI":"10.18433\/J3TG6H","article-title":"Effects of pioglitazone on erectile dysfunction in sildenafil poor-responders: A randomized, controlled study","volume":"11","author":"Gholamine","year":"2008","journal-title":"J. Pharm. Pharm. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2174\/1568026620666191224141617","article-title":"Mechanisms and Characteristics of Sulfonylureas and Glinides","volume":"20","author":"Lv","year":"2020","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0022-5347(05)64920-8","article-title":"Potassium channels and human corporeal smooth muscle cell tone: Diabetes and relaxation of human corpus cavernosum smooth muscle by adenosine triphosphate sensitive potassium channel openers","volume":"168","author":"Venkateswarlu","year":"2002","journal-title":"J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1111\/andr.12099","article-title":"Adding liraglutide to lifestyle changes, metformin and testosterone therapy boosts erectile function in diabetic obese men with overt hypogonadism","volume":"3","author":"Giagulli","year":"2015","journal-title":"Andrology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"608","DOI":"10.2164\/jandrol.111.013714","article-title":"Addition of metformin to sildenafil treatment for erectile dysfunction in eugonadal nondiabetic men with insulin resistance. A prospective, randomized, double-blind pilot study","volume":"33","author":"Costanzo","year":"2012","journal-title":"J. Androl."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2026. Diabetes Care, 49, S261\u2013S276.","DOI":"10.2337\/dc26-S012"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2026. Diabetes Care, 49, S61\u2013S88.","DOI":"10.2337\/dc26-S004"},{"key":"ref_22","first-page":"108","article-title":"Evaluation of Erectile Dysfunction Using the International Index of Erectile Function-5 (IIEF-5) in 200 Urological Patients","volume":"11","author":"Chang","year":"2000","journal-title":"Urol. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2024). 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2024. Diabetes Care, 47, S111\u2013S125.","DOI":"10.2337\/dc24-S006"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Defeudis, G., Di Tommaso, A.M., Di Rosa, C., Cimadomo, D., Khazrai, Y.M., Faggiano, A., Cincione, R.I., Napoli, N., and Mazzilli, R. (2022). The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes. J. Clin. Med., 11.","DOI":"10.3390\/jcm11123382"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1177\/1932296818794704","article-title":"Exploratory CSII Randomized Controlled Trial on Erectile Dysfunction in T2DM Patients (ECSIITED)","volume":"12","author":"Kesavadev","year":"2018","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Cignarelli, A., Genchi, V.A., D\u2019Oria, R., Giordano, F., Caruso, I., Perrini, S., Natalicchio, A., Laviola, L., and Giorgino, F. (2021). Role of Glucose-Lowering Medications in Erectile Dysfunction. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112501"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.urology.2003.10.071","article-title":"Role of ATP-sensitive K+ channels in relaxation of penile resistance arteries","volume":"63","author":"Benedito","year":"2004","journal-title":"Urology"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:20:48Z","timestamp":1775449248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["life16040597"],"URL":"https:\/\/doi.org\/10.3390\/life16040597","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,3]]}}}