As we continue to discuss bladder health, we need to look at the role of diabetes in bladder health. November is Diabetes Awareness month, as well as bladder health month. I wanted to share some interesting information about how diabetes actually increases the risk of urinary incontinence.
Type 2 Diabetes increases the risk of urinary incontinence by 50-70%. This is a huge increase in risk compared to the general population. In women with relatively well controlled diabetes type 2, the risk comes mainly from microvascular changes in the bladder (detrusor) muscle and damage to the nerves of the bladder. This is similar to the microvascular changes seen in the eyes and peripheral nerves in people with diabetes.
Research shows that incontinence is highly prevalent in women with pre-diabetes as well. This is directly related to poor control of blood sugars. Among women with relatively well controlled diabetes and those who are pre-diabetic, each 1% increase in A1c is associated with a 34% increase in stress urinary incontinence. A1c is is a simple blood test that measures your average blood sugar levels. Normal range is below 5.7%.
Again—for each 1% increase in A1c, there is a corresponding 34% increase in stress incontinence!
So, how can we improve these odds?
A 3-year study of women with diabetes and stress urinary incontinence, divided women into an exercise group and a medication only group, treated with metformin (a medication used to treat diabetes). Women in the exercise group had a significant improvement in urinary incontinence vs the medication management group. The largest factor in the improvement of stress incontinence was found to be weight management. This makes sense, higher body weight = increased pressure on the pelvic floor and bladder. A 5-10% decrease in body weight showed a significant improvement in incontinence, and blood sugar — a double positive!
Weight reduction and increased physical activity help to treat both diabetes and urinary incontinence. However, incontinence can be a barrier to physical activity. This is where pelvic floor physical therapy can help! A pelvic floor physical therapist will design an individualized program to improve strength, weight loss and improve incontinence. Addressing these issues can feel like a mountain to climb, but we promise, seeing a pelvic physical therapist is one easy step that will make it feel like you can and will gain control over both your bladder and your blood sugar!
We offer a free 15 minute phone consultation with one of our PT specialists to answer questions and see how integrative physical therapy can be beneficial for you. We work to bring an integrative, whole person approach to our practice and will work with your on all the lifestyle factors that can help you reach your wellness goals and reduce your stress and pain.