title: Prevalence and risk factors for urinary incontinence in overweight and obese diabetic women: action for health in diabetes (look ahead) study.
abstract: OBJECTIVE To determine the prevalence and risk factors for urinary incontinence among different racial/ethnic groups of overweight and obese women with type 2 diabetes. RESEARCH DESIGN AND METHODS Cross-sectional analysis of baseline data from the Action for Health in Diabetes (Look AHEAD) study, a randomized clinical trial with 2,994 overweight/obese women with type 2 diabetes. RESULTS Weekly incontinence (27%) was reported more often than other diabetes-associated complications, including retinopathy (7.5%), microalbuminuria (2.2%), and neuropathy (1.5%). The prevalence of weekly incontinence was highest among non-Hispanic whites (32%) and lowest among African Americans (18%), and Asians (12%) (P < 0.001). Asian and African American women had lower odds of weekly incontinence compared with non-Hispanic whites (75 and 55% lower, respectively; P < 0.001). Women with a BMI of > or =35 kg/m(2) had a higher odds of overall and stress incontinence (55-85% higher; P < 0.03) compared with that for nonobese women. Risk factors for overall incontinence, as well as for stress and urgency incontinence, included prior hysterectomy (40-80% increased risk; P < 0.01) and urinary tract infection in the prior year (55-90% increased risk; P < 0.001). CONCLUSIONS Among overweight and obese women with type 2 diabetes, urinary incontinence is highly prevalent and far exceeds the prevalence of other diabetes complications. Racial/ethnic differences in incontinence prevalence are similar to those in women without diabetes, affecting non-Hispanic whites more than Asians and African Americans. Increasing obesity (BMI > or =35 kg/m(2)) was the strongest modifiable risk factor for overall incontinence and stress incontinence in this diverse cohort.
authors.affiliation: Kinesiology Department, California Polytechnic State University, San Luis Obispo, California, USA. sphelan@calpoly.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Hogan
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Vicki
authors.initials: V
authors.lastname: Dilillo
authors.forename: Amy A
authors.initials: AA
authors.lastname: Gorin
authors.forename: Delia S
authors.initials: DS
authors.lastname: West
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American