Sexual dysfunction in patients with Type 2 diabetes: A South Asian perspective

A single-author narrative review argues South Asian diabetes clinics routinely skip sexual health screening entirely

Journal: Best Practice & Research. Clinical Endocrinology & Metabolism | Published: 2026-05-09 | Type: Journal Article, Review | PMID: 42225446 Authors: Selim Shahjada (Department of Endocrinology, Bangladesh Medical University, Bangladesh) Funding/COI: Funding not listed; author declares no competing interests

Summary

This is a narrative review, not a study with new data, arguing that sexual dysfunction in Type 2 diabetes is underdiagnosed in South Asian clinical practice because of sociocultural taboo and thin regional research. It walks through erectile dysfunction in men and a broader, less-studied cluster of symptoms in women (low desire, poor lubrication, anorgasmia, dyspareunia), attributing both to a mix of vascular damage, autonomic neuropathy, hormonal shifts, and psychosocial factors. The paper's own headline point is that female sexual dysfunction in this population is barely studied at all.

Claims

• Erectile dysfunction is described as the most common manifestation of diabetes-related sexual dysfunction in men, and may precede clinically apparent cardiovascular disease, reflecting shared endothelial and vascular pathology
• Female sexual dysfunction in diabetes is framed as more heterogeneous than male ED, spanning desire, arousal/lubrication, orgasm, and pain domains
• The review states there is a significant regional and gender data gap, i.e., most existing evidence on diabetes-related sexual dysfunction is not South Asia-specific and skews toward men
• Mechanisms proposed: vascular compromise, autonomic neuropathy, hormonal imbalance, plus sociocultural and psychological contributors
• Newer glucose-lowering drug classes are flagged as having "potential implications" for sexual health outcomes, without the review reporting specific trial effect sizes

Study Quality

This is a narrative review by a single author, with no stated systematic search strategy, no PRISMA-style methodology, no inclusion/exclusion criteria, and no quality appraisal of the primary studies it draws on. That means there's no way for a reader to check whether the cited literature was comprehensively surveyed or cherry-picked to support a pre-existing thesis. The abstract itself is largely descriptive and programmatic ("comprehensive evaluation includes...", "management requires a holistic approach"), which is typical of this review format but means the paper is a synthesis of others' evidence quality, not a generator of new data.

The core argument, that South Asian and female-specific data are sparse, is itself unverifiable from the abstract alone; it would need checking against the review's reference list to see how many South Asian and female-focused studies were actually located versus assumed absent.

Red Flags

• Single author, no co-authors or institutional review process visible
• No systematic methodology disclosed (search terms, databases, date range, or exclusion criteria)
• No funding statement at all ("Not listed"), which is itself a disclosure gap for a journal article
• Claims about "emerging glucose-lowering therapies" and sexual health are described only as having "potential implications," not backed by specific trial data in the abstract
• Full text was not reviewed here; assessment is based on the abstract only, so specific citation counts, sample sizes of underlying studies, and reference list composition are unverified

Strengths

• Addresses a genuinely under-researched population (South Asian patients with diabetes-related sexual dysfunction)
• Explicitly separates male and female presentations rather than defaulting to ED-only framing, which is a common blind spot in this literature
• Names the sociocultural and communication barriers that suppress reporting, rather than treating underdiagnosis as purely a clinical knowledge gap
• Published in a specialty endocrinology journal with editorial review

Verdict

Worth a skim if you're tracking gaps in diabetes and sexual health research, not worth citing as evidence for any specific mechanism or treatment claim. It's an opinionated narrative review from one author with no disclosed search methodology, no funding transparency, and a female-sexual-dysfunction argument that rests on "the data isn't there" rather than presenting new data itself. Treat it as a pointer to where research is missing, not as a source of numbers.