title: Weight loss prevents urinary incontinence in women with type 2 diabetes: results from the Look AHEAD trial.
abstract: OBJECTIVE
  We determined the effect of weight loss on the prevalence, incidence and resolution of weekly or more frequent urinary incontinence in overweight/obese women with type 2 diabetes after 1 year of intervention in the Look AHEAD (Action for Health in Diabetes) trial.
  
  
  METHODS
  Women in this substudy (2,739, mean ± SD age 57.9 ± 6.8 years, body mass index 36.5 ± 6.1 kg/m(2)) were randomized into an intensive lifestyle weight loss intervention or a diabetes support and education control condition.
  
  
  RESULTS
  At baseline 27% of participants reported urinary incontinence on a validated questionnaire (no significant difference by intensive lifestyle intervention vs diabetes support and education). After 1 year of intervention the intensive lifestyle intervention group in this substudy lost 7.7 ± 7.0 vs 0.7 ± 5.0 kg in the diabetes support and education group. At 1 year fewer women in the intensive lifestyle intervention group reported urinary incontinence (25.3% vs 28.6% in the diabetes support and education group, p = 0.05). Among participants without urinary incontinence at baseline 10.5% of intensive lifestyle intervention and 14.0% of diabetes support and education participants experienced urinary incontinence after 1 year (p = 0.02). There were no significant group differences in the resolution of urinary incontinence (p >0.17). Each kg of weight lost was associated with a 3% reduction in the odds of urinary incontinence developing (p = 0.01), and weight losses of 5% to 10% reduced these odds by 47% (p = 0.002).
  
  
  CONCLUSIONS
  Moderate weight loss reduced the incidence but did not improve the resolution rates of urinary incontinence at 1 year among overweight/obese women with type 2 diabetes. Weight loss interventions should be considered for the prevention of urinary incontinence in overweight/obese women with diabetes.
authors.affiliation: Kinesiology Department, California Polytechnic State University, San Luis Obispo, California 93407-0386, 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: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D015431:Weight Loss