Prevalence and risk factors for urinary incontinence in women with type 2 diabetes and impaired fasting glucose: findings from the National Health and Nutrition Examination Survey (NHANES) 2001-2002.
OBJECTIVE
Diabetes is associated with increased risk of urinary incontinence. It is unknown whether women with pre-diabetes, or impaired fasting glucose (IFG), have increased prevalence of incontinence. We determined the prevalence of, and risk factors for, incontinence among U.S. women with diabetes and IFG.


METHODS
The 2001-2002 National Health and Nutrition Examination Survey measured fasting plasma glucose and obtained information about diabetes and urinary incontinence among 1,461 nonpregnant adult women. Self-reported weekly or more frequent incontinence, both overall and by type (urge and stress), was our outcome.


RESULTS
Of the 1,461 women, 17% had diabetes and 11% met criteria for IFG. Prevalence of weekly incontinence was similar among women in these two groups (35.4 and 33.4%, respectively) and significantly higher than among women with normal fasting glucose (16.8%); both urge and stress incontinence were increased. In addition to well-recognized risk factors including age, weight, and oral estrogen use, two microvascular complications caused by diabetes, specifically macroalbuminuria and peripheral neuropathic pain, were associated with incontinence.


CONCLUSIONS
Physicians should be alert for incontinence, an often unrecognized and therefore undertreated disorder, among women with diabetes and IFG, in particular those with microvascular complications. The additional prospect of improvements in their incontinence may help motivate some high-risk women to undertake difficult lifestyle changes to reduce their more serious risk of diabetes and its sequelae.
Brown
Jeanette S
JS
Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF Women's Health Clinical Research Center, University of California-San Francisco, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115, USA. brownj@obgyn.ucsf.edu
Vittinghoff
Eric
E
Lin
Feng
F
Nyberg
Leroy M
LM
Kusek
John W
JW
Kanaya
Alka M
AM
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000652:urine; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000652:urine; D006801:Humans; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D011336:Probability; D044469:Racial Groups; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000503:physiopathology