Passing Excess Urine in Women with Diabetes: Understanding the Real Cause

Good question, and very common in OPD. In women with diabetes, “frequent urination” can happen for different reasons, and the treatment changes based on the cause.

How to tell the difference, in simple terms

1) High sugar polyuria

• You pass large amounts of urine each time.
• Thirst is usually more.
• Often happens when sugars are high and glucose spills into urine.

2) Urinary incontinence

• You may pass small amounts, but you feel urgency and may leak on the way.
• Stress leakage: leakage with cough, sneeze, laughing, lifting.
• Urgency leakage (overactive bladder): sudden urge, cannot hold. These are standard incontinence patterns.^[6]

3) UTI

• Burning, smell, lower abdominal discomfort, sometimes fever.
• Diabetes increases UTI risk in women, so we should not miss it. ^[5]

4) Diabetes-related bladder nerve issue

• Poor bladder sensation, incomplete emptying, recurrent infections, dribbling. This is part of diabetic bladder dysfunction in some patients.^[4]

What I usually advise first

• Check fasting and post-meal sugars and HbA1c.
• Urine routine and urine culture if there is any burning, smell, or repeated symptoms.
• A simple bladder diary for 2-3 days: timing, amount, leaks, triggers. This is recommended in standard evaluation.^[3]
• If you feel incomplete emptying or recurrent UTIs, your doctor may check post-void residual urine (scan) in selected cases.^[1]

Practical takeaway:

In diabetes, it is not “one single cause.” Most women have a mix like mild sugar-related polyuria plus urgency incontinence plus occasional UTIs. Once we identify the pattern, treatment becomes straightforward. Please discuss your exact symptoms with your doctor rather than self-treating.