Effect of intensive glycemic control and diabetes complications on lower urinary tract symptoms in men with type 1 diabetes: Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study.
OBJECTIVE
Although diabetes is known to result in lower urinary tract symptoms (LUTS) in men, it remains unclear if glycemic control can mitigate urinary symptoms. We studied how diabetic characteristics are related to LUTS in the men who completed the urological assessment component (UroEDIC) of the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study of the Diabetes Control and Complications Trial (DCCT) participants.


METHODS
Study participants were men who completed the UroEDIC questionnaire at the year 10 DCCT/EDIC follow-up examination, which included data on genitourinary tract function and the American Urological Association Symptom Index (AUASI). Analyses were conducted to assess how treatment arm and diabetes characteristics were associated with LUTS using logistic regression.


RESULTS
Of the 591 men who completed the AUASI questions, nearly 20% (n = 115) had AUASI scores in the moderate to severe category for LUTS (AUASI score >or=8). No associations were observed between LUTS and treatment arm, or A1C levels at the DCCT baseline or end-of-study or at the year 10 EDIC (UroEDIC) examination. Of the diabetes complications studied, only erectile dysfunction at the UroEDIC examination was associated with LUTS.


CONCLUSIONS
These data from the UroEDIC cohort do not support the assumption that intensive glycemic control results in decreased lower urinary tract symptom severity in men with type 1 diabetes. This result may be due to a true lack of effect, or it may be due to other factors, for example, the relatively young age of the cohort.
Van Den Eeden
Stephen K
SK
Division of Research, Kaiser Permanente, Northern California Region, Oakland, California, USA. stephen.vandeneeden@kp.org
Sarma
Aruna V
AV
Rutledge
Brandy N
BN
Cleary
Patricia A
PA
Kusek
John W
JW
Nyberg
Leroy M
LM
McVary
Kevin T
KT
Wessells
Hunter
H
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D001745:Urinary Bladder Diseases / Q000453:epidemiology; D014555:Urination Disorders / Q000097:blood / Q000453:epidemiology; D014570:Urologic Diseases / Q000097:blood* / Q000453:epidemiology*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin