Erectile dysfunction currently occurs in 10-15% of men but there is a distinct variance with age. 40% of men at 40 yrs. report some degree of erectile dysfunction and 70% at the age of 70 yrs. (Gregoire 1999) Bowering (2001) points out the fact that other factors can also affect the eventual incidence of the cardiovascular complications of Diabetes Mellitus such as blood pressure and smoking. Both of these factors are known to be positively and independently associated with erectile dysfunction so it is not surprising for them to be found in relation to Diabetes Mellitus. Some of the most recent research shows that, as far as Type I diabetes mellitus is concerned, a reduction in HbA1 by 10% will reduce cardiovascular complications (both micro- and macro-vascular) by a factor of between 34-76%. On the face of it, that looks impressive, but the difficulty is that by increasing the insulin dosage to ensure better control, the patient is put at greater risk of potentially having hypoglycaemic attacks. In direct consideration of our topic, Bowering (2001) also states the fact that atherosclerosis is a major complication of Diabetes Mellitus. Brief consideration of the physiological and anatomy of the erectile mechanism will tell us that the presence of atherosclerotic vessels will seriously impede the blood flow to the penis which clearly will not be as responsive to the triggers to erection as normal. The need for change
The need for change is highlighted in documents such as the National Service Framework which were produced by the Government after a major review of the NHS service provision. The National Service Framework specifically target areas where the provision was found to be inadequate together with the setting of targets that help those areas where provision is optimal. With regard to the subject of this essay the major sections of relevance to the diabetic are: Standard 11
The NHS will develop, implement and monitor agreed...
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