Women with type 2 diabetes face an increased risk of urinary urge incontinence, but 17 percent of incontinence of any quantity and nearly 15 percent of severe incontinence can be avoided with the prevention of diabetes. "Because many studies have shown that women often do not mention their incontinence to physicians, medical evaluation of patients with diabetes might include screening for incontinence, along with discussion of diagnostic and treatment options," the authors suggest.
Limited previous research suggests that diabetes contributes to urinary problems, Dr. Karen L. Lifford from Harvard Medical School, Boston and colleagues explain in the Journal of the American Geriatrics Society.
To further investigate this relationship, the team used data from the Nurses Health Study to compare the risk of urinary incontinence in women with type 2 diabetes with that in women without diabetes.
Between 1996 and 2000, the rate of incontinence was 10.5 percent in women with diabetes and 7.0 percent in those without diabetes, the authors report.
After accounting for age as a potentially contributing factor, women with diabetes had a 28-percent greater risk of being incontinent than women without diabetes, and a 21-percent increased risk of developing incontinence. This risk was more pronounced for larger quantities of leakage, the results indicate.
Longer duration of diabetes increased the risk of incontinence further, the researchers note, so that women who had diabetes for more than 10 years had nearly a 50-percent greater risk of developing incontinence. Moreover, women whose diabetes affected the small blood vessels had more than double the risk of developing incontinence compared with those without this complication.
The results were similar after excluding obese women, subjects with a history of stroke, those reporting substantial functional limitations, and women who smoked.
"Overall, in this population of women, 17 percent of incontinence of any quantity and nearly 15 percent of severe incontinence can be avoided with the prevention of diabetes," the investigators suggest.
As they point out, "Diabetes is a largely preventable condition, and studies have indicated that weight loss may decrease diabetes, as well as urinary incontinence."
"In particular," the researchers add, "given the increasing risk of incontinence with increasing duration of diabetes, even delaying onset of diabetes could substantially reduce the medical, emotional and financial burdens of incontinence for older women."
Journal of the American Geriatrics Society, November 2005.