title: Glycaemic control and risk of incident urinary incontinence in women with Type 1 diabetes: results from the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study.
abstract: To study the impact of glycaemic control on urinary incontinence in women who participated in the Diabetes Control and Complications Trial (DCCT; 1983-1993) and its observational follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC; 1994-present).
  
  
  
  Study participants were women who completed, at both years 10 (2003) and 17 (2010) of the EDIC follow-up, the urological assessment questionnaire (UroEDIC). Urinary incontinence was defined as self-reported involuntary leakage of urine that occurred at least weekly. Incident urinary incontinence was defined as weekly urinary incontinence present at EDIC year 17 but not at EDIC year 10. Multivariable regression models were used to examine the association of incident urinary incontinence with comorbid prevalent conditions and glycaemic control (mean HbA1cover the first 10 years of EDIC).
  
  
  
  A total of 64 (15.3%) women with Type 1 diabetes (mean age 43.6 ± 6.3 years at EDIC year 10) reported incident urinary incontinence at EDIC year 17. When adjusted for clinical covariates (including age, DCCT cohort assignment, DCCT treatment arm, BMI, insulin dosage, parity, hysterectomy, autonomic neuropathy and urinary tract infection in the last year), the mean EDIC HbA1cwas associated with increased odds of incident urinary incontinence (odds ratio 1.03, 95% CI 1.01-1.06 per mmol/mol increase; odds ratio 1.41, 95% CI 1.07-1.89 per % HbA1cincrease).
  
  
  
  Incident urinary incontinence was associated with higher HbA1clevels in women with Type 1 diabetes, independent of other recognized risk factors. These results suggest the potential for women to modify their risk of urinary incontinence with improved glycaemic control. (Clinical Trials Registry no: NCT00360815 and NCT00360893).
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI, USA.|Department of Surgery, Division of Urology, University of Utah, Salt Lake City, UT, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Lenherr
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Clemens
authors.affiliation: Biostatistics Center, George Washington University, Rockville, MD, USA.
authors.forename: B H
authors.initials: BH
authors.lastname: Braffett
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Dunn
authors.affiliation: Biostatistics Center, George Washington University, Rockville, MD, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Cleary
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Herman
authors.affiliation: Department of Surgery, Division of Urology, University of Utah, Salt Lake City, UT, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Hotaling
authors.affiliation: Winthrop University Hospital, Research Institute, Mineola, NY, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Jacobson
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA.|Department of Urology, University of California, San Francisco, CA, USA.|Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Brown
authors.affiliation: Department of Urology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Wessells
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI, USA. asarma@umich.edu.
authors.forename: A V
authors.initials: AV
authors.lastname: Sarma
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin