Older Women With Diabetes Have a Higher Risk for Poor Bladder Control

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Older Women With Diabetes Have a Higher Risk for Poor Bladder Control
American Diabetes Association

What is the problem and what is known about it so far?



Research shows that as women get older, 69% of them will have more problems controlling their bladders than men. Women who have trouble controlling their bladders often feel embarrassed, suffer a lower quality of life, are depressed, and lose their independence.

Having diabetes and being overweight or obese has been shown to be connected to loss of bladder control for a number of reasons. First, being overweight or obese means that there is more fat in the body that can put pressure on the bladder. Second, people who are overweight or obese are more likely to develop type 2 diabetes and, in turn, nerve problems and infections that can cause the muscles of the bladder to weaken. Third, people with diabetes, especially those taking insulin, are more likely to get urinary tract infections, which can also lead to the loss of bladder control.

Most of the studies on bladder control and diabetes have so far focused on elderly men and women who were taking insulin and who already had nerve and urinary problems due to old age. Little is known, however, about whether blood glucose levels, diabetes complications, and the length of time someone has had diabetes are connected to loss of bladder control in older women.

Why did the researchers do this particular study?



This study was done to see if there is a connection between having diabetes and loss of bladder control in women who have gone through menopause.

Menopause is a stage in life when a woman stops having her monthly period. By definition, a woman is menopausal after her periods have stopped for 1 year.

Who was studied?



The researchers studied 1,017 women between the ages of 55 and 75 years who have gone through menopause and were originally part of a study on urinary tract infections. Two hundred and eighteen of these women had diabetes. The women were from the Pierce, King, or Snohomish communities in Washington State and were members of the Group Health Cooperative.

How was the study done?



First, the researchers interviewed the women in the study to find out about their general health, whether they have had surgery or were on hormone replacement therapy, their history of urinary tract infections, and their diabetes status. The women who had diabetes were asked to fill out a questionnaire. The women were then given a clinical exam where their urine and blood were tested.

To measure bladder control, the researchers used the Sandvik Index. The Sandvik Index measures how much urine the women made and how often they lost control of their bladder. The researchers also measured “stress incontinence” (losing control of your bladder when you laugh, cough, sneeze, or do any physical activity) and “urge incontinence” (losing control of your bladder when you feel the urge to urinate).

What did the researchers find?



The study showed that 60% of the women in the study had problems controlling their bladder, and 8% of these cases were severe. Hormone replacement therapy was shown to increase the risk of bladder control problems. Having a history of urinary tract infections was also shown to increase the risk.

Women with diabetes were more likely to have more severe cases of loss of bladder control, have both stress and urge incontinence, use pads, have a hard time completely emptying their bladder, be unaware of leakage, and have discomfort while urinating.

What were the limitations of the study?



The women in the study were from a previous study on urinary tract infections, making them more likely to have bladder control problems. In addition, the women themselves reported their own bladder control problems, their own height and weight measurements, and how long they have had diabetes and/or diabetes complications. Some of the women may have provided inaccurate or incorrect information.

What are the implications of the study?



Not being able to control your bladder is a problem for many women after they go through menopause. For women with diabetes, controlling their weight seems to be the best way to control severe bladder control problems.