The odds of urinary incontinence increase with poor glycemic control in women with type 1 diabetes, according to recent study findings.

Sara M. Lenherr, MD, MS, a clinical lecturer in urology at the University of Michigan in Ann Arbor, and colleagues analyzed data from 417 women participating in the Diabetes Control and Complications Trial (DCCT) and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Women completed urologic self-assessment questionnaires during follow-up at years 10 (2003) and 17 (2010). 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. Researchers used multivariable regression models to examine the association between incident urinary incontinence, glycemic control (mean HbA1c over the first 10 years of EDIC) and prevalent comorbid conditions.

Within the cohort, 64 women with type 1 diabetes (mean age, 43.6 years at EDIC year 10) reported at least weekly incident urinary incontinence at EDIC year 17. Women with incident weekly urinary incontinence had a higher mean HbA1c at EDIC year 1 (8.3% vs. 7.8%) and year 10 (8.4% vs. 7.8%) vs. women who did not develop urinary incontinence. 

After adjustment for age, DCCT treatment group, DCCT cohort assignment, BMI, EDIC mean daily insulin dose, parity, hysterectomy, autonomic neuropathy and urinary tract infection, researchers found that mean EDIC HbA1c was associated with increased odds of incident urinary incontinence (OR = 1.03; 95% CI, 1.01-1.06 per mmol/mol increase; OR = 1.41; 95% CI, 1.07-1.89 per % HbA1c increase).

“After adjustment for previously well-described risk factors, we observed a 3% and 41% increased odds of incident weekly [urinary incontinence] with each 1-mmol/mol and 1% increase in HbA1c level, respectively, in women with type 1 diabetes,” the researchers wrote. “These data suggest that long-term glycemic control may independently affect the development of [urinary incontinence] in this population.”

Disclosure: The researchers report no relevant financial disclosures.



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