Erectile dysfunction: prevalence, associated factors, and quality of life in men with diabetes mellitus in Kuala Lumpur

Erectile dysfunction (ED) is a frequent adverse consequence among males with diabetes and can significantly affect their physical, emotional, and social quality of life. The objective of this study was to determine the prevalence of ED, identify sociodemographic and clinical factors associated with ED, and evaluate the quality of life among male diabetes patients in Kuala Lumpur. A cross-sectional study was conducted among 374 male patients attending diabetes clinics in Kuala Lumpur, using stratified sampling from public health clinics. The International Index of Erectile Function (IIEF-15) and the WHOQoL-BREF (Malay version) were used to collect the data. Descriptive statistics, simple logistic regression, and one-way ANOVA were performed. The overall prevalence of ED in this study was 65.5% (21.1% mild to moderate, 24.9% moderate, and 19.5% severe). Younger adults (25-39 years) and those with higher levels of education had significantly lower odds of ED (p=0.018). Clinically, ED was significantly correlated with a longer duration of diabetes (AOR = 1.179, p = 0.012), the presence of comorbidity (AOR = 2.59, p = 0.04), and reduced levels of exercise (AOR = 0.031-0.083, p = 0.033). There were substantial differences in QoL scores across ED severity strata (p < 0.001), with the social domain most affected. All QoL domains were the lowest among participants with severe ED. Age, education, clinical conditions, and lifestyle (smoking, diabetes, and hypertension) have a profound impact, with ED being widespread. QoL impairment is significant, highlighting the need to integrate structured ED screening into standard diabetes care protocols to ensure earlier detection, targeted intervention, and more responsive clinical management for affected patients.