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letter
. 2013 Oct 15;36(11):e191. doi: 10.2337/dc13-1699

Response to Comment on: Wing et al. Effect of Intensive Lifestyle Intervention on Sexual Dysfunction in Women With Type 2 Diabetes: Results From an Ancillary Look AHEAD Study. Diabetes Care 2013;36:2937–2944

Rena R Wing 1,, Dale S Bond 1, Isaias Noel Gendrano III 2, Thomas Wadden 3, Judy Bahnson 4, Cora E Lewis 5, Stephen Schneider 6, Abbas E Kitabchi 7, Brent Van Dorsten 8,9, Raymond C Rosen 10; the Sexual Dysfunction Subgroup of the Look AHEAD Research Group
PMCID: PMC3816887  PMID: 24159186

Our recent publication (1) focuses on the changes in sexual function that occurred in overweight or obese individuals with type 2 diabetes who were randomly assigned to intensive lifestyle intervention or a comparison condition. The primary finding was that the intensive lifestyle intervention had positive effects on those women who reported sexual dysfunction at baseline. Although data are presented on the prevalence of sexual dysfunction in this cohort at baseline, the primary goal of the study was not to provide a precise estimate of the prevalence of sexual dysfunction in obese women with diabetes. The limited sample size and the extensive selection criteria raise concerns about using these data to estimate prevalence of sexual dysfunction in the general population of women with diabetes. Thus, we were surprised by the comment by Maiorino et al. (2), which focuses entirely on the prevalence estimates. Moreover, although neither our trial, nor previous studies cited (3,4), used representative samples, the prevalence of sexual dysfunction in each of these reports was high, ranging from 50 to 60%. Rather than focusing on the slight differences between these studies, the important point appears to be that the prevalence of sexual dysfunction is high in these samples of women with diabetes.

As discussed in our article, we agree with the point that sexual inactivity may be a response to sexual dysfunction. However, we also note that the female sexual function index (5) is designed to assess sexual dysfunction in women who are sexually active. Moreover, we feel it is most appropriate to use 26.55 as the cutoff as this is the empirically validated cutoff value.

Given the fact that sexual dysfunction is common in women with diabetes, our study suggests that lifestyle intervention may be beneficial for these individuals.

Acknowledgments

No potential conflicts of interest relevant to this article were reported.

References

  • 1.Wing RR, Bond DS, Gendrano IN, 3rd, et al. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study. Diabetes Care 2013;36:2937–2944 [DOI] [PMC free article] [PubMed]
  • 2.Maiorino MI, Petrizzo M, Bellastella G, Esposito K. Comment on: Wing et al. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study. Diabetes Care 2013;36:2937–2944 (Letter). Diabetes Care 2013;36:e190. DOI: 10.2337/dc13-1495 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Esposito K, Maiorino MI, Bellastella G, Giugliano F, Romano M, Giugliano D. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res 2010;22:179–184 [DOI] [PubMed] [Google Scholar]
  • 4.Abu Ali RM, Al Hajeri RM, Khader YS, Shegem NS, Ajlouni KM. Sexual dysfunction in Jordanian diabetic women. Diabetes Care 2008;31:1580–1581 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Rosen R, Brown C, Heiman J, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208 [DOI] [PubMed] [Google Scholar]

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