Diabetes mellitus and female urinary incontinence: a time for change

Excerpt

Diabetes mellitus (DM), a chronic metabolic disease, is becoming a global health problem with increasing prevalence. The incidence of type I DM is fairly constant but that of type II DM is on the rise, most likely as a consequence of the contemporary changes in lifestyle, increasing obesity rates, and aging of the female population. DM is considered an independent risk factor for female urinary incontinence (UI); in a pooled analysis of 71,650 women aged 37–79 years, Danforth et al. [1] showed a 20 % increased odds of UI in women with DM [odds ratio (OR) 1.2, 95 % confidence interval (CI) 1.0–1.3, p = 0.01)] This was largely because of urgency UI with no apparent association with stress or mixed UI. In a study of the Turkish population, Izci et al. [2] has shown a 2.5-fold increase in prevalence of UI in diabetic women, mainly of mixed UI. Similar results were shown in studies from Taiwanese, Chinese, and South American female populations. Despite this evidence, the management of incontinent diabetic women has been relatively neglected by the urogynecology community. This is partly because the etiology of DM is not well understood and partly due to lack of training in diabetic medicine in most urogynecology training programs. …