title: Associations between lower urinary tract dysfunction and glycemic control in women with type 2 diabetes: A cross-sectional study.
abstract: OBJECTIVE
  Patients with diabetes are predisposed to develop a variety of complications, including lower urinary tract (LUT) dysfunction. We aimed to examine the associations between glycemic control and LUT dysfunction in women with type 2 diabetes (T2D).
  
  
  METHODS
  We included 400 women with T2D (age range, 48-75 years) in this cross-sectional analysis. The participants were divided into tertiles according to glycosylated hemoglobin (HbA1c) measurements. The mean HbA1c levels for tertiles 1, 2, and 3 were 6.2% (N=132), 7.1% (N=132), and 8.4% (N=136), respectively. We evaluated LUT dysfunction with the American Urological Association Symptom Index (AUA-SI) questionnaire, uroflowmetry (UFM), and post-void residual (PVR).
  
  
  RESULTS
  No significant differences were found among HbA1c tertiles regarding storage, voiding and total AUA-SI scores, and prevalence of LUT symptoms. However, women in tertile 3 had higher prevalences of severe LUT symptoms (AUA-SI≥20) and clinically significant PVR (≥100mL) compared to women in the other tertiles. Multivariate analysis revealed that diabetic neuropathy, but not HbA1c, significantly predicted LUT symptoms in women with T2D after adjustment for age, body mass index (BMI) and hypertension. However, HbA1c was associated with an increased risk of developing clinically significant PVR.
  
  
  CONCLUSIONS
  Our findings do not support significant associations between glycemic control and LUT symptoms in women with T2D. However, women with poor glycemic control are more likely to develop urinary retention than women with proper glycemic control. Clinicians should, therefore, be aware of and educate patients about the association between urinary retention and glycemic control.
authors: Department of Urology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institution of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: taihuai48@hotmail.com.
authors: Huai-Ching
authors: HC
authors: Tai
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, Taipei Jen Chi Hospital, Taipei, Taiwan.
authors: Tong-Yuan
authors: TY
authors: Tai
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institution of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Wei-Shiung
authors: WS
authors: Yang
authors: Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
authors: Shin-Wei
authors: SW
authors: Wang
authors: Department of Urology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: yhj5251@ntu.edu.tw.
authors: Hong-Jeng
authors: HJ
authors: Yu
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000097:blood* / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D014551:Urinary Tract / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Diabetes mellitus; Glycemic control; Glycosylated hemoglobin; Lower urinary tract symptoms; Uroflowmetry