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Diabetes is a common medical issue that affects many Americans. In fact, around 37.3 million adults in the U.S. have diabetes. High blood sugar levels and problems with the heart, nerves, and eyes are typical health complications associated with this disease, but what may be more surprising is that diabetes is also a significant risk factor for urinary incontinence.
The good news is that there are actionable steps you can take to manage the loss of bladder control related to diabetes. In this post, we’ll explore the causes of diabetes incontinence and different ways to address the issue.
Diabetes can cause urinary incontinence or UI. One study found that people with the disease were 2.5 times more likely to have incontinence than those who don’t.
For some people, diabetes could be the sole underlying cause of bladder problems, but often, there is more than one reason why a person experiences a loss of bladder control. Read on to learn more about the link between diabetes and incontinence.
Diabetes mellitus is a chronic health condition marked by abnormally high blood glucose or blood sugar levels. In a person without diabetes, a hormone produced by the pancreas called insulin helps to keep blood sugar in check.
Type 1 diabetes happens when the pancreas doesn’t produce insulin properly. This condition often begins during childhood or adolescence and tends to run in families. With type 2 diabetes, the body cells either don’t respond properly to insulin or the pancreas doesn’t produce enough high-quality insulin to control blood sugar. In many cases, type 2 diabetes is preventable and caused by factors like obesity and a sedentary lifestyle.
Although the causes differ, type 1 and type 2 diabetes can affect the body in several ways. Blood sugar can damage large blood vessels in the body, causing damage to the cardiovascular system, raising blood pressure, and increasing the risk of heart attack and stroke. Elevated blood glucose can also cause changes in small blood vessels, leading to nerve dysfunction, vision problems, and kidney damage.
In addition to its effects on the blood vessels, diabetes can impact the reproductive system, resulting in sexual problems like erectile dysfunction in men and vaginal dryness in women. Uncontrolled diabetes also interferes with immune system activity, so you’re at an increased risk for yeast infections, urinary tract infections (UTIs), and other types of infections if you have the disease.
Long-term diabetes can cause a few types of incontinence. Let's examine the effects that the condition has directly on the urinary system and how they can lead to bladder control issues.
Diabetic neuropathy is nerve damage caused by diabetes. It can affect any of the nerves in the body and interfere with the transmission of signals to and from the brain. When the nerves that control the bladder or the pelvic floor muscles that support the lower urinary tract become damaged, one of the following types of incontinence may occur:
Neuropathy can also injure the nerves that control the bowel, causing fecal incontinence—the inability to control bowel movements.
In people with uncontrolled diabetes, excess glucose in the blood increases urine production as the body attempts to eliminate the sugar. As urination increases, so does thirst, which in turn produces more urine. This cycle can lead to functional incontinence, which is an inability to hold in urine until you can reach the toilet. Older adults with mobility issues are particularly susceptible to this type of diabetes incontinence.
Sometimes, diabetes treatments contribute to incontinence. Some oral diabetes medications work by directing excess sugar into the urine. The presence of more sugar in the bladder can lead to bladder irritation, which can worsen an overactive bladder and other forms of incontinence.
The symptoms of diabetes incontinence vary. If you have bladder dysfunction due to the disease, you may experience:
While anyone with diabetes may develop bladder problems, certain people are at a greater risk. Some risk factors for the condition include:
Although there is no cure for diabetes or incontinence associated with the disease, you can take steps to reduce your risk of developing it or improve your symptoms if you already have it.
A healthy lifestyle can greatly improve outcomes for people with diabetes. Some lifestyle changes that you can make include:
Depending on the type of incontinence you have, your doctor may prescribe medications for your bladder control symptoms. This is especially true if you have severe incontinence or lifestyle changes alone don't improve your symptoms. These medications may include:
If your diabetes medication contributes to your incontinence symptoms, talk to your doctor. They may be able to prescribe a different drug to manage diabetes.
No matter what type of incontinence you have, pelvic floor exercises and bladder training may improve your symptoms. A physical therapist can teach you how to perform Kegel exercises that involve tensing and relaxing your pelvic floor and other exercises to increase muscle tone and provide more support for your bladder.
Bladder training involves creating a regular schedule for bathroom visits. Even if you don’t feel like you need to urinate when a scheduled toilet break arrives, you still try to pee. Over time, your body may adapt to the schedule, making you less likely to experience urinary urgency and leakage.
When lifestyle changes don’t fully address incontinence, medical providers may recommend other interventions, such as:
If you have diabetes incontinence, self-care can help you manage the effects of urine leakage.
Bladder protection products absorb urine and lock it away so you stay dry. You can choose from pads and guards that you place inside your underwear or incontinence underwear that you wear instead of your usual undergarments. Moderate absorbency products may be the best solution for light, occasional leakage. Maximum and overnight absorbency products are ideal for those with moderate to severe incontinence.
In some cases, Medicare Part C, Medicaid, and private health insurance may help you pay for bladder protection products. Generally, your doctor will need to write you a prescription to show that they’re medically necessary.
To look and feel your best while using incontinence protection products, follow these tips:
Do you struggle with diabetes incontinence? Take our bladder protection quiz and get a free sample pack to try.
Izci Y, Topsever P, Filiz TM, Cinar ND, Uludağ C, Lagro-Janssen T. The association between diabetes mellitus and urinary incontinence in adult women. Int Urogynecol J Pelvic Floor Dysfunct. 2009 Aug;20(8):947-52. doi: 10.1007/s00192-009-0888-8. Epub 2009 Apr 30. PMID: 19404561; PMCID: PMC2706373.
Centers for Disease Control and Prevention. (2021). National diabetes statistics report, 2020. Retrieved from https://www.cdc.gov/diabetes/data/statistics-report/index.html