Up to 15 million American adults struggle with urinary incontinence each day. Several health issues have been listed as potential urinary incontinence causes.
For many, it is their diabetes that is causing them to lose control over their bladder.
The link between diabetes and incontinence is rather a complex one. In today’s article, we will review everything that you need to know about it.
Diabetes and urinary incontinence
Diabetes mellitus, or diabetes as it is popularly known, is a common metabolic disease. In the case of diabetes, blood sugar levels are significantly higher compared to those of a healthy individual.
It all has to do with a very important hormone known by the name of insulin. Insulin is the hormone that transports the blood sugar into the cells, where it can be used as a primary energy source. In diabetic patients, their bodies either do not produce enough insulin or the insulin is not properly used.
There are a few different types of diabetes. Diabetes type 1 is an autoimmune disease that affects up to 10% of diabetic patients. Gestational diabetes refers to high blood sugar levels during pregnancy.
By far, the most common type is diabetes type 2. In those with diabetes type 2, their bodies have become resistant to insulin, allowing for the blood sugar to build up in the blood. This is a condition that is caused by unhealthy lifestyle choices, overweight/obesity, being physically inactive, etc.
Diabetes often causes serious complications. If left untreated, it can easily lead to:
- Neuropathy
- Dementia
- Hearing loss
- Vision loss
- Skin issues
- Heart attack
- Heart disease
- Stroke
- Kidney damage/kidney disease
- Fecal incontinence/urinary incontinence, etc.
Today, we are here to discuss the link between diabetes and incontinence, primarily urinary incontinence. Fecal incontinence refers to the inability to control one’s bowel movements. This causes an involuntary bowel movement to take place; thus, stool leakage takes place. On the other hand, urinary incontinence refers to the involuntary urine leakage.
Research has demonstrated a significantly high prevalence of urinary incontinence in diabetic patients. And it seems that women are more commonly affected by this type of bladder dysfunction, whether it is caused by diabetes or not. Diabetic women have a 70% higher risk of developing urinary incontinence.
A 2007 study compared the urinary incontinence prevalence in women with and without diabetes. Results showed that the prevalence of urinary incontinence among those with diabetes was at 39%. Compared to those results, only 29% of the women without diabetes struggled with urinary incontinence.
In women, the most common urinary tract issue is diabetic cytopathic, also known as neurogenic bladder. Bladder cystopathy characterizes by a decreased bladder sensitivity and an inability for the bladder muscle to contract. This results in the patient’s inability to fully empty their bladder. Diabetic cystopathy affects as much as 25%-90% of diabetes patients.
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Types of urinary incontinence
Over the years, several different urinary incontinence types have been identified. While the majority of causes and symptoms are the same, there are still some distinct differences between them. It is these differences that make it easier to diagnose the exact issue.
Urge incontinence
Urge incontinence refers to the sudden urge to urinate. The diabetic patient feels a sudden, strong urge to urinate, one that he/she has no control of. Overactive bladder is also a common term that refers to urge incontinence.
Nocturia, which is when you wake up during the night because of a strong need to urinate, is a common urge incontinence symptom. The patient may also experience frequent urination as well as a sudden urine leakage as they reach the bathroom or even when they hear the sound of running water.
In healthy individuals, their bladder fills with urine and stretches like a balloon. This sends a signal to the brain, which is how we feel the need to urinate. The bladder muscle will then contract to expel urine, but only upon getting the proper permission. In those with urge incontinence, their bladder contracts suddenly and involuntary. Thus, urge incontinence takes place.
The urgency urinary incontinence is quite common among diabetic patients. In this case, the most common cause is diabetic neuropathy, but it may also be caused due to an infection to the lower urinary tract. Urge incontinence is often caused by inflammation of the urinary bladder, which is a common case among those struggling with diabetes mellitus.
Stress incontinence
Stress incontinence is yet another common type of urinary incontinence. In this case, the loss of urine occurs in certain circumferences. When we say stress incontinence, it is important to mention that this condition has nothing to do with emotional stress.
Instead, it has everything to do with the physical pressure on the bladder. You see, any type of pressure on the bladder leads to stress urinary incontinence.
Laughing, sneezing, coughing, and exercising are some of the common causes of urine leakage in those with stress urinary incontinence. This is, in fact, a very serious issue that most patients feel embarrassed about. Many of them are hiding in social isolation because of the symptoms that they experience.
The most common cause of stress incontinence in pregnancy and childbirth. Many women experience loss of bowel control and bladder issues after giving birth, especially those who have multiple vaginal deliveries. This happens because of the weakened and even damaged pelvic floor muscle.
In men, it is prostate surgery that most often leads to a case of stress incontinence. But diabetes, too, can lead to stress incontinence as well. With that being said, both diabetic women and men can struggle with stress incontinence as a major diabetes complication.
Mixed incontinence
Mixed incontinence refers to the combination of urge and stress urinary incontinence. Since we are talking about a combination of the two conditions, symptoms of both urge and stress incontinence are expected to happen. However, usually one of the two different types will predominate. In this case, the bladder control can be disrupted by any factor whatsoever, including diabetes.
Overflow incontinence
We mentioned urge and stress incontinence because of defects in the bladder that prevent it from properly storing urine. Well, overflow incontinence occurs because of incorrect emptying of the urinary bladder. In healthy individuals, the bladder naturally empties during the act of urination.
However, in those with overflow incontinence, a small amount of urine is left behind. The bladder then becomes too full, which later leads to urine spilling out and leaking accidents happening.
Patients with overflow incontinence often experience frequent urinary tract infections. They may also experience nocturia as well as trouble when initiating a urine stream. Overflow incontinence is one of the most common urinary tract issues in older individuals. As much as half of the American adults over the age of 65 experience overflow incontinence.
While chronic urinary retention remains the most common cause of overflow incontinence, we often see diabetes as a cause. By causing nerve damage to the bladder, diabetes leads to chronic urinary incontinence.
Functional incontinence
And last but not least significant bladder control problem is the so-called functional incontinence. Functional incontinence is unlike any other urinary incontinence type. In the case of functional incontinence, the cause is not linked to any of the urinary, muscular, or neurological systems.
Instead, this type of incontinence is caused by either physical barriers or mental issues that make it difficult for the patient to use the toilet in time. Vision issues, dementia, delirium, and neurological limitations are some of the most common functional incontinence causes. In this case, diabetes is rarely the cause of unintentional urine leakage.
What is the link between diabetes and urinary incontinence?
Researchers are still working on finding an answer as to how exactly does diabetes cause urinary incontinence. Although there is still no clear answer, there are four possibilities that need to be considered.
- Obesity – We mentioned obesity being one of the leading causes of diabetes type 2. Obesity puts extra pressure on all body organs, including your bladder. It is not unlikely that the extra pressure may be what is causing the urinary incontinence in diabetic patients.
- Nerve damage – So far, we know that untreated diabetes causes nerve damage, otherwise known as neuropathy. This is a serious, and yet common, a complication of both diabetes type 1 and type 2. The problem occurs due to long-term high blood sugar levels. In this case, we are talking about a case of neurogenic bladder.
Neurogenic bladder refers to the urinary issues that take place due to a brain, nerve, or spinal cord problem. And so, this is a common issue in those with Parkinson’s disease, multiple sclerosis, and diabetes. Diabetes may also lead to what is known as autonomic neuropathy. Autonomic neuropathy refers to a group of symptoms that take place due to nerve damage to different body parts. In return, the patient may experience issues linked to their blood pressure, bowel and bladder emptying, sweating, etc. - Compromised immune system – Diabetic patients often struggle with a compromised immune function. This makes them more vulnerable to all kinds of infections, including urinary tract infections. It is not uncommon for urinary tract infections to lead to severe incontinence.
- Use of diabetes medications – Even if you do not struggle with obesity,
diabetic neuropathy, or a compromised immune system, your diabetes medications may be causing the lower urinary tract symptoms.
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Treatment
So now that we know what urinary incontinence is, it is time to discuss how we can treat the diabetic bladder. What is there to be done about diabetes and incontinence?
The first step involves educating yourself on the topic. Reading this article is a good place to start, but do not stop there. Use other resources as well to get as much information as possible.
The next step would be to discuss the symptoms with your doctor. Let your doctor know all about your symptoms and any additional issues that you may struggle with.
They can help diagnose the issue and later provide proper treatment. The good news is that there are a few different treatment options that you can rely on.
- Drug therapy – Drug therapy can provide significant relief, especially in the case of urge incontinence. There are a few medications that you can try out before you find the one that works best for you.
- Kegel exercises – Kegel exercises are special exercises designed to strengthen the pelvic floor muscles. By strengthening your pelvic floor muscles, you can successfully relieve both urge and stress incontinence symptoms.
- Bladder retraining – Bladder retraining refers to scheduled visits to the toilet. The goal is to relearn normal bladder function.
- Insertion devices – Different insertion devices can be used in both men and women. These devices help patients avoid urine leakage. They seem to be most effective in cases of stress incontinence.
Other treatments are available as well. For the sake of staying on topic, we only mentioned the most popular ones. We should also mention that surgery is a possibility, although it is used only as the last option.
Tips for management and prevention
Managing your urinary incontinence symptoms takes a lot of effort. It also goes beyond taking your prescription medications and doing your Kegels. Diabetes and urinary incontinence require some serious lifestyle changes in addition to the prescribed treatment.
That is the only way to relieve the present symptoms, but also prevent any further complications. Besides, these lifestyle changes will also help anyone prevent the occurrence of diabetes and urinary incontinence.
- Maintain a healthy weight – We mentioned obesity as one of the risk factors for diabetes and urinary incontinence. So, if you want to prevent any of these two conditions, you must maintain a healthy weight. Eating a balanced diet and working out daily can help you achieve that. Ensure that your diet is filled with fresh fruits and veggies and lean protein while limiting your intake of processed food, fast food, and other empty calories. Aim for at least 30-minute physical activity each day. Whether it is walking, jogging, swimming, or cycling, the choice is up to you.
- Avoid alcohol – Limit your intake of alcohol. Alcohol is a great irritant to your urinary system. Drinking too much alcohol has also been linked to several health issues beyond diabetes. Knowing that limiting your alcohol intake is key for preserving your good health.
- Quit smoking – Smoking, too, contributes to the development of many health issues, including diabetes and urinary incontinence. Please consider quitting smoking.
- Give herbal remedies a try – Many herbal remedies can help manage and prevent diabetes and urinary incontinence. Curcumin and berberine are by far the most popular ones, and we highly recommend including them in your daily routine.
Conclusion
Diabetes and urinary incontinence are both serious issues. Each of them has its challenges as it limits the individual to pursue even the simplest tasks of their everyday life. Unfortunately, many of them are struggling with both issues at the same time.
What seems to be the reason for that and how to manage the conditions, is something that we tried to explain with today’s article. For any additional help that you may require, please consult your primary physician.
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