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NICE-aligned management typically involves: Addressing modifiable risk factors (smoking cessation, weight loss, increased physical activity, alcohol reduction) Optimising management of underlying conditions (diabetes, hypertension, depression) Trial of PDE5 inhibitor therapy Referral to specialist services (urology/andrology) if first-line treatments fail or where structural/neurological/endocrine causes are suspected Consideration of psychosexual therapy where appropriate Men should be reassured that ED is a medical condition with effective treatments, and seeking help through proper channels ensures safety, appropriate investigation of underlying causes, and access to evidence-based therapies

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International Diabetes Federation Nathan D et al (2006) Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy

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