Type 2 Diabetic Patient Experience with Sexual Dysfunction

Imelda Sirait¹, Setiawan², Rosina Tarigan³

¹Master Students of Medical Surgical Nursing, Faculty of Nursing, University of Sumatera Utara,
²Dean Faculty of Nursing, University of Sumatera Utara, Medan, Indonesia
email: imeldasirait22@yahoo.com

Keywords : Experience, diabetes mellitus, sexual dysfunction

Abstract : Type 2 diabetic patient are often hesitant to submit sex topics to health care providers because they feel
embarrassed or may think that they should not experience sexual problems. The purpose of this study is to
explore the experiences of type 2 diabetic patients who experience sexual dysfunction. Research on patients'
experience with type 2 diabetic is reviewed between 2012 and 2017. The method used through the internet is
IOSR Journal, CINAHL, Proquest, and EBSCO. Keywords used type 2 diabetes mellitus, sexual dysfunction,
sexuality, sex. 30 atricle have been explored. From article, there were only 10 article that focused on
information exploring type 2 diabetic patients who experienced sexual dysfunction. The results obtained that
the experience of patients with diabetes mellitus who experience sexual dysfunction feel less perfect to be a
partner and cause depression, stress, emotional instability, and anxiety. The conclusion of patients with
diabetes mellitus has a poor experience and this affects the quality of life of patients. Suggestions for diabetes
mellitus patients improve understanding to use health services.

1. INTRODUCTION
Diabetes mellitus is a syndrome with impaired
metabolism of carbohydrates, fats, and proteins
caused by reduced insulin secretion or decreased
tissue sensitivity to insulin (Ermita, et al. 2016).
According to the International Diabetes Federation
(2015), people with diabetes mellitus will increase in
number by 2040 to around 642 million people.
Patients with diabetes mellitus with sexual
dysfunction will experience libido, ejaculatory
disorders and erectile dysfunction (Salama, 2013).
Patients with diabetes mellitus with the frequency of
erectile dysfunction will increase four times more at
the age of 40-70 years (Laura & Eneas, 2015).
Problems that arise as a result of sexual dysfunction
have an impact on individual quality of life which
leads to an increase in psychological effects and
social influences associated with diabetes mellitus
(Mosayeb, et al., 2015; Taniguchi, et al., 2014).
Patients with type 2 diabetes mellitus are often
hesitant to present sex topics to health care providers
because they feel embarrassed or may think that they
should not experience sexual problems. So it is
necessary to explore the experience of type 2
diabetes mellitus patients who experience sexual
dysfunction.
2. METHOD
Journal search was conducted through electronic
media and searched for variables to be studied and
there were two variables, type 2 diabetes mellitus
with the key to search for "Type 2 Diabetes
Mellitus" and the second variable was sexual
dysfunction with the search for keywords "Sexual
dysfunction", "Sexuality" " Sex "through the IOSR-
JNHS (Journal of Nursing and Health Science),
CINAHL, Proquest, and EBSCO.
There are 10 journals conducted in a systematic
review review consisting of research titles / journals,
objectives, research designs, population,
instruments, results, themes, and countries.
The research design used in this study was
phenomenological study, grounded theory, literature
review, retrospective review, descriptive study, and
cross sectional study.
The instruments used were interview guides with
semi structure interview (open-ended question),
International Index of Erectile Function (IIEF),
Female Sexual Function Inventory (FSFI), and Beck
Depression Inventory-II (BDI-II).
 2 Chapter Error! No text of specified style in document.

1 RESULT say that gays with diabetes mellitus experience

psychological disorders such as stress, anxiety, and
Study design is quantitative, qualitative, and low self-esteem because they are unable to satisfy
mixed methods. All research comes from various their partners.
countries, with research from Brazil, India,
Australia, United Kingdom, Iran, Istanbul, Las
Vegas, Egypt. The study focused on the experience
of type 2 diabetes mellitus patients who experience
sexual dysfunction. 4 DISCUSSION
30 article were identified In the study of Juana (2016) says that men and
using the electronic database women experience sexual dysfunction who
IOSR Journal, CINAHL, experience depression as much as 70.7%, and do not
Proquest, and EBSCO have a good quality of life as much as 22%.
According to the assumption of researchers: patients
with diabetes mellitus will be more prone to
depression and higher anxiety. Sexual needs are
n = 16 basic needs that must be met. Therefore, good
excluded: coping management is needed that can affect
o Only psychological factors that are disrupted.
abstract Based on the research (Husin, 2017) said that
o Not related the highest prevalence in patients with sexual
to sex 14articles dysfunction was accompanied by 52.6% diabetes
related to the wounds and 95% depression. According to the
topic assumption of the researcher: diabetes mellitus
patients who have wounds with no injuries have
similar levels of depression and anxiety. There is no
injury affecting the patient's psychological because
n=4 exlcluded: they will feel imperfect to be a partner. Patients with
o Non diabetes mellitus are no longer able to meet sexual
English needs as a husband and wife. Therefore we need
support from partners, spirituality approach, family
and friends compared to the health profession
10 article were related (Janice, 2015)
and full text which Coupled with the results of research from
included this review: Leyla, et al (2013) said that men with diabetes
diabetes mellitus tipe 2 mellitus who experience erectile dysfunction have
and sexual dysfunction an impact on the emotional life and quality of life of
patients. The assumption of the researcher: patients
with diabetes mellitus have a higher emotional level
that is influenced by disease factors and inability to
3 Figure 1. Flow Chart of Selection meet sexual needs. Therefore, a spiritual approach
and support from the family environment is needed.
In the study of Juana (2016) said that as many Changes in sexual standards in male sexuality must
as 78.3% of men experienced sexual dysfunction be understood from the socio-cultural context which
and 66.9% of women experienced sexual is reflected in health education (Laura, 2015)
dysfunction who experienced depression as much as Coupled with the results of research from
Jowet, et al (2012) said that gays with diabetes
70.7%, and did not have a good quality of life as
mellitus experience psychological disorders such as
much as 22%. In Husin's (2017) study, the highest stress, anxiety, and low self-esteem because they are
prevalence in patients with sexual dysfunction was unable to satisfy their partners. According to the
accompanied by 52.6% of diabetic wounds and 95% assumption of the researcher: the level of stress and
depression. In the study Leyla, et al (2013) said that anxiety will surely occur in patients with diabetes
patients with diabetes mellitus who experience mellitus, because there will arise self-rejection and
tend to blame themselves. Gay patients will fear
sexual dysfunction have an impact on the emotional losing their partners. They are afraid of being
life and quality of life of patients. Jowet, et al (2012)
Error! No text of specified style in document.. Authors’ Instructions 3

abandoned by their partners. Therefore, there needs Australians with Type 2 Diabetes. Journal of
to be an approach and education from health Clinical Nursing. DOI : 10.1111/jocn.12724
workers that must be done to gay people who Mosayeb, et al. (2014). Evaluation of Sexual Function in
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Research Center. Iranian Journal of Diabetes and
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Salama, et al. (2013). Sexual Dysfunction as Self Reported
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5 CONCLUSIONS Based Study in Alexandria, Egypt. American
Journal of Medical and Biological Research Volume
1 (3), 50-57. DOI : 10.12691/ajmbr-1-3-1
The conclusion of patients with diabetes mellitus has a Sonjia, et al. (2014). Sexual Dysfunction among Latino
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patients. Patient with sexual dysfunction feel less perfect Journal of Health Disparities Research and
to be a partner and cause depression, stress, emotional Practice Volume 7 (1), 53-64
instability, and anxiety. Taniguchi, et al. (2014). Acupuncture in the Treatment of
Erectile Dysfunction among a Diabetic Population
of Sildenafil Citrate Non-Respnder. Japanese
Acupuncture and Moxibustion Volume 10 (1), 14-17
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in patients with anxiety and Permaisuri Bainun ("HADS") both with and without
diabetes mellitus with depression as Ipoh, Perak 2. International Index for diabetic foot ulcer. In the
and without foot ulcer primary outcome Erectile Function 5 group with foot ulcer, 36.8%
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International Medical secondary outcome Female Sexual without the foot ulcer, 37.5%
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2- Yazd Diabetes patients with Yazd Diabetes characteristics of Informing the patient as the
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Between Depression relationship Descriptive study were willing to Inventory-II (BDI-II) was depression score of 16.34 ±
and Perception between depression participate in the administered to evaluate 8.06. The average level of
of Sexuality in Patients and perceptions of study and met the depression. The participant depression was higher in
with Type II Diabetes: sexuality in people participant criteria form gathered information women, those whose level of
In Turkey with type 2 about individual education was low, and the
diabetes. characteristics and included unemployed. Of the
Leyla, et al (2012) 16 questions about participants, 53% reported
sexuality. that diabetes has affected their
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no relationship between level
of depression and aspects of
the illness. However, level of
depression was related to
sexual satisfaction. Findings
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sexually related problems
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diabetes
Sexual Dysfunction Aimed to know Quantitative study : 300 Latino Diabetic : Female Sexual Function Result did not find any Las Vegas
among Latino Men sexual dysfunction Descriptive study 150 men Inventory (FSFI) significant associations
and Women with among Latino Men 150 women between sexual dysfunction
Poorly Controlled and Women with International Erectile and depression and also did
Diabetes poorly controlled To qualify for the Function Instrument (IEFI) not find a linear correlation
diabetes study patients between glycemic control and
Sonjia, et al (2014) 1. Between 30-70 sexual dysfunction. We
years of age concluded that interventions
Journal of Health 2. Diagnosed with are needed to address high
Disparities Research diabetes for at rates of sexual dysfunction
and Practice Volume 7, least 6 months among Latinos with diabetes
Issue 1, 53-64 3. Had at least one with particular emphasis on
HbA1c >=8 in the Latina women, who were
past year much more likely than men to
report problems with desire
and other areas of sexual
functioning.
Sexual Dysfunctions as To document the Retrospective review 276 consecutive Erectile dysfunction (ED) was Mesir
Self-Reported by prevalence of self- diabetic men who frequent in the diabetic
Diabetic- Type 2 Men: reported sexual presented with patients and the only
An Andrology Clinic- dysfunctions in complaints of sexual complaint in 54.7%. The
Based Study in diabetic type 2 men dysfunction at in the remaining patients had more
Alexandria, Egypt attending the Alexandria University than one (compound)
andrology clinic in General Hospital in complaint. Erectile
Nader Salama (2013) the Alexandria Alexandria, A control dysfunction (42.7%),
University Hospital group consisting of premature ejaculation (22.1%)
American Journal of 100 consecutive non- and low libido (11.7%) were
Medical and Biological diabetic patients who the most frequent sexual
Research, 2013, Vol. 1, consulted the clinic dysfunction in these
No. 3, 50-57 during the same time compound complaints. They
period were enrolled often joined together in the
patients. Less frequently
reported sexual dysfunction
were anejaculation (7.2%),
penile curvature (4.4%),
small-sized penis (2.5%) and
penile plaques (0.7%). Penile
pain and delayed and painful
ejaculations were the rarest
reported