News in brief: Can T2D treatment improve erectile dysfunction?; Optimum dose intervals for testosterone injections; Sleep disruption in noisy wards

Wednesday, 23 Jun 2021

Can T2D treatment improve erectile dysfunction?

Long-term use of dulaglutide might reduce the incidence of moderate or severe erectile dysfunction in men with type 2 diabetes.

In the REWIND trial, designed to look at the effect of dulaglutide on cardiovascular outcomes, male participants were invited to complete the International Index of Erectile Function (IIEF) questionnaire at baseline and a number of subsequent time points.

The study found 40% of men had cardiovascular disease and 56.5% had moderate to severe erectile dysfunction at baseline.

The incidence of erectile dysfunction following randomisation was 21·3 per 100 person-years in the dulaglutide group and 22·0 per 100 person-years in the placebo group (HR 0·92, 95% CI 0·85–0·99, p=0·021).

Men in the dulaglutide group also had a lesser fall in erectile function subscore compared with the placebo group, with a least square mean difference of 0·61 (95% CI 0·18–1·05, p=0·006).

The Lancet Diabetes & Endocrinology

Real world data: 12 week injection intervals for TRT

A prospective surveillance study of testosterone undecanoate (TU) injections in routine clinical practice – including hypogonadal men and transmen – has confirmed the optimal injection interval of 12 weeks.

The NSW study of 6,899 individually optimised injections to 325 patients found 10 – 14 weeks was the optimised interval for 70% of patients.

The interval was significantly influenced by age and body surface area but not by diagnosis or trough serum LH, FSH and SHBG.

“An important observation is that the pharmacology of injectable TU does not differ materially between hypogonadal and transgender men,” the study said.

“However, the present findings do not identify any practical workaround to bypass the need for individual dose titration based on lead symptom relief and runoff together with trough serum testosterone.”

Endocrine Connections

Quiet please: noise the main reason for sleep disruption in hospitals

Almost half of hospital inpatients have their sleep disrupted, with noise being the main culprit, Australian research shows.

A study involving 60 patients at Melbourne’s Box Hill hospital found that sleep was disturbed in 45% of patients, with the problem common to those in shared rooms and those in single rooms distant from the nursing station.

Lighting levels were appropriately low across all the ward locations studied, whereas sound levels were higher in the shared and single rooms group compared to a ‘control’ setting of a sleep laboratory. Noise was also rated as the greatest environmental disturbance by 70% of ward patients compared to 10% in the sleep laboratory.

Operational interruptions were also a major factor in disrupted sleep, with patients experiencing an average of around six per night, according to the findings published in Sleep and Breathing.

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