Diabetes and Urinary Incontinence

Diabetes is often associated with the early onset and increased severity of urinary incontinence. Women with diabetes usually have up to a 70% greater risk of developing this condition. This seems to be a progressive condition which involved many symptoms including:

• Urinary urgency – strong pressure to void
• Frequent daytime and nighttime voiding
• Incontinence

The exact way that diabetes causes incontinence is not known. But, it is known that high blood glucose can cause an increase in the amount of urine produced which results in urgency, frequent urination and possible incontinence. It is also theorized that autonomic neuropathy damages the nerves of the bladder which possibly causing incontinence to some extend.

The ability to control urination may be affected by several diabetes-related factors:

• Chronic high blood glucose levels may create the need for frequent urination
• Vaginitis, or vaginal yeast infections
• Nerve damage can cause the bladder to empty irregularly with episodes alternating between sudden loss of urine to the inability to void.

It is also believed that in people with diabetes, obesity (in particular abdominal fat) may be a factor in urinary incontinence.

Factors

There are many other factors which connect diabetes and urinary incontinence:

• Believed to be connected to obesity. This is because obesity causes the extra weight which is placed on the floor muscles of the pelvis.
• Affected nerve function in the bowel and bladder. Damaged nerves can cause changes in the function of the bladder.
• Bladder overactivity leads to urge incontinence as well as urgency
• Reduced sensation in the bladder which leads to no or little warning before needing to urinate
• With severe or/and long existent diabetes, this weakens the muscle bladder so there is an inability to for the bladder to empty completely with each urination. This leaves residual urine which often leads to infections of the urinary tract. This can lead to overflow incontinence.
• Diabetes that is not controlled well and blood glucose are very high; the body tries to rid extra sugar through urination.
• Constipation can make empting the bladder difficult.
• Congestive heart failure caused by coronary artery disease which is diabetes-related often causes the feet and legs to keep water. This often causes the body to produce so much urine during the night leading to incontinence during sleep.
• Diabetic-related stroke affects sensations in the bladder and being able to hold urine.
• Challenges because of diabetic neuropathy, amputation, peripheral vascular disease that prevents subject getting to the toilet in time.
• Some diabetes medications or medications for diabetes complications may cause this problem.
• Medications can cause retention of fluid in the feet and legs
• Some subjects have a cough caused by ACE inhibitors used in treating blood pressure which is high. This cough can cause stress urinary incontinence.
• Calcium channel blockers taken for hypertension may keep the bladder from contracting and emptying completely causes overflow incontinence.

Prevention

One of the better ways to keep incontinence linked to diabetes from occurring is:

• Diabetes prevention
• Work with your doctor on controlling blood glucose levels as well as any hypertension, obesity and high cholesterol. Those who are diagnosed with pre-diabetes should take part in a prevention program with focus on exercise and diet can reduce the episodes of urinary incontinence. Research has shown that women who are overweight who lower the diabetes risk also lower the incontinence risk.

Management and Treatment

Something which persons who have diabetes or pre-diabetes need to share this problem with your doctor if you are have urgent urination, nighttime over urinating or develop incontinence. Those diabetics with incontinence often are embarrassed to tell their doctor. There are a wide variety of options including:

• Absorbent products
• Artificial sphincter surgery for fecal incontinence
• Artificial sphincter surgery for urinary incontinence
• Avoiding bladder irritants
• Biofeedback
• Bladder retraining
• Outline toxin injections
• Bowel retraining
• Bulking agents
• Catheters (intermittent, indwelling, suprapubic)
• Dietary changes for fecal incontinence
• Electric stimulation of the pelvic floor
• Fiber therapy
• Hormone replacement therapy (HRT)
• Medications or laxatives for fecal incontinence
• Medications for overactive bladder (OAB)
• Pelvic floor exercises
• Penile clamps
• Pessary
• Sacral nerve stimulation
• Stem cells
• Surgery for pelvic organ prolapse (POP)
• Surgery for stress urinary incontinence (SUI)
• Urine collection devices for men
• Vaginal weights or cones for women

An important note to remember is that incontinence is not always caused by diabetes in every instead. There are many separate factors that can cause Incontinence.