Clinical research in diabetes and urinary incontinence: what we know and need to know.

Abstract

We discuss epidemiological and clinical trial research in women with urinary incontinence and diabetes, and provide directions for future research. Published epidemiological and clinical trial literature examining diabetes and incontinence is presented. Multiple studies have now confirmed that the prevalence and incidence of incontinence is increased in women with type 2 diabetes. Emerging evidence also suggests higher incontinence rates in women with type 1 diabetes or prediabetes. Clinical trial research suggests that weight loss can decrease incontinence in women with prediabetes. An ongoing multicenter trial will examine the effects of weight loss on incontinence in women with type 2 diabetes. Limited trial data in those with type 1 diabetes suggest that intensive glycemic control does not appear to decrease the long-term risk of incontinence in women with type 1 diabetes. Future research is needed to identify the risk factors, mechanisms, and most effective treatment and prevention strategies to decrease urinary incontinence in women with type 1 or 2 diabetes, or prediabetes. Physicians should be alert for urinary incontinence because it is often not reported and, therefore, it is under treated in women with diabetes and prediabetes.