INS and diabetes mellitus: PDE5Is have proven anti‐inflammatory effects in diabetes‐induced endothelial dysfunction (Schwartz, Jackson et al., 2013) and recent evidence suggests that PDE5Is have additional direct effects on glucose metabolism: Significant improvements in insulin sensitivity and glucose uptake have been demonstrated in the muscles of mice fed a high‐fat diet following 12‐week sildenafil treatment, suggesting that PDE5I therapy may improve energy balance and prevent insulin resistance (Ayala, Bracy et al., 2007).