title: Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with type 2 diabetes: results from the Look AHEAD trial.
abstract: OBJECTIVE
  We determined the effect of an intensive lifestyle intervention on the prevalence, incidence and resolution of bothersome nocturia, increased daytime urinary voiding and urinary incontinence in overweight/obese men with type 2 diabetes after 1 year in the Look AHEAD trial.
  
  
  METHODS
  A subset of male Look AHEAD participants was selected for this secondary data analysis. Overall 1,910 men with an average (mean ± SD) age of 59.9 ± 6.7 years and body mass index of 35.2 ± 5.5 kg/m(2) were randomized to an intensive lifestyle intervention or diabetes support and education group. All participants self-reported information regarding incontinence, nocturia and daytime urinary voiding at entry and 1 year.
  
  
  RESULTS
  After 1 year the intensive lifestyle intervention group lost significantly more weight than the diabetes support and education group (9.4% ± 7.0% vs 0.7% ± 4.5%, respectively; p <0.001). The odds of prevalent urinary incontinence at 1 year were reduced by 38% in the intensive lifestyle intervention group compared to the diabetes support and education group. The prevalence of urinary incontinence decreased from 11.3% to 9.0% in the intensive lifestyle intervention group and increased from 9.7% to 11.6% in the diabetes support and education group. The intensive lifestyle intervention group also had increased odds of urinary incontinence resolving (OR 1.93, 95% CI 1.04-3.59, p = 0.04 and 56.0% vs 40.7%, p = 0.03) and trend toward reduced odds of new onset, incident urinary incontinence (OR 0.66, 95% CI 0.42-1.02, p = 0.06) compared with the diabetes support and education arm. In contrast, no differences between intensive lifestyle intervention and diabetes support and education were seen at 1 year for frequency of nocturia or frequency of daytime voiding.
  
  
  CONCLUSIONS
  Intensive lifestyle intervention should be considered for the treatment of urinary incontinence in overweight/obese men with type 2 diabetes.
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, California. Electronic address: bbreyer@urology.ucsf.edu.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
authors.affiliation: Kinesiology Department, California Polytechnic State University, San Luis Obispo, California.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Phelan
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Hogan
authors.affiliation: New England Research Institutes, Watertown, Massachusetts.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
authors.affiliation: Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Abbas E
authors.initials: AE
authors.lastname: Kitabchi
authors.affiliation: Department of Psychiatry and Human Behavior, Brown Medical School and The Miriam Hospital, Providence, Rhode Island.
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
authors.affiliation: Departments of Obstetrics, Gynecology and Reproductive Sciences; Urology and Epidemiology, UCSF Women's Health Clinical Research Center, San Francisco, California.
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000628:therapy*; D050177:Overweight / Q000150:complications* / Q000628:therapy*; D016037:Single-Blind Method; D014549:Urinary Incontinence / Q000209:etiology* / Q000517:prevention & control*
keywords: diabetes mellitus; nocturia; urinary incontinence; weight loss