Diabetes and incontinence?

It's no secret that diabetes patients are more susceptible to certain conditions. But diabetes also seems to affect an annoying ailment that is still taboo for many people, namely incontinence. Unwanted urine loss is not in itself a dangerous condition, but it does lead to feelings of shame that prevent people from leaving the house. Sometimes incontinence can be part of serious bladder problems.

More frequent incontinence in diabetics

About one in twenty Dutch people suffer from unwanted urine and/or fecal loss. Incontinence is more common in women than in men. Out Norwegian research It appears that female diabetes patients suffer from incontinence more often than women without diabetes. Another 2009 study published in the 'Journal of Urology' confirms a higher rate of incontinence among diabetes patients.

Neuropathy and incontinence

One of the main reasons why people with diabetes are more likely to suffer from unwanted urine loss is neuropathy, or nerve damage. About four in ten diabetics suffer from neuropathy. Due to significant changes in blood glucose levels, the nerves receive less oxygen and nutrients. The nerve pathways can be damaged and even die.

Overflow incontinence

Nerve damage can affect the bladder in the form of overflow incontinence. Due to nerve damage, the bladder can no longer squeeze properly to remove urine from the body. Urine is retained for too long, causing the bladder to become overfull and hypersensitive. This manifests itself in the unwanted loss of drops or even dashes of urine. There is also a regular urge to urinate, but only a small amount of urine is lost.

Urge incontinence

Not only a neurological disorder can be the cause of incontinence. In case of urge incontinence, abnormalities in metabolism may be the reason. This is caused by diabetes. The bladder muscles contract more often and unexpectedly and the bladder becomes overactive. There is a spontaneous urge to urinate and this is difficult to stop. It is often not possible to get to the toilet on time, resulting in unwanted urine loss.

Other causes

Not only is the unbalanced blood sugar level the basis for the unwanted urine loss. Factors that play a role in type 2 diabetes, such as alcohol, smoking, obesity, lack of exercise and too much saturated fat, also have an influence. Finally, unwanted urine loss can be a result of certain medications that diabetics take. It is a side effect of, for example, blood pressure lowering agents such as water pills (diuretics), muscle relaxants and pain-relieving medication.

Bladder problems

As previously mentioned, incontinence can be part of a broader bladder problem. The nerve damage has a negative impact on the urinary system. Based on a number of indicators, a doctor can determine whether the diabetes patient suffers from serious bladder problems:

• A bladder infection a few times a year
• Having a feeling of a bladder that is not completely emptied
• Having difficulty urinating
• Needing to urinate less than four times a day
• Regular unwanted urine loss

What can you do about incontinence with diabetes?

People with diabetes cannot get rid of neuropathy, but they can limit the symptoms by living a healthy lifestyle and keeping their glucose levels in balance. During the annual checkups, the doctor will also check for diabetic neuropathy. Always take urinary problems seriously. Visit the doctor and have your urinary tract checked regularly. A referral to a urologist is a possibility. Blood sugar-lowering medications can be a solution, if they do not have side effects that actually stimulate urine loss. Sometimes it is necessary to catheterize, because it is impossible to pass all the urine independently. Absorbent incontinence material can also be used in daily life. This allows unwanted urine loss to be collected locally.

Pelvic floor muscles

Sometimes pelvic physiotherapists can provide support. They cannot do anything about the nerve damage, but incontinence can be limited with the help of tips about urination. For example, a relaxed pelvic floor is necessary for easy urination. The pelvic physiotherapist will explain where this pelvic floor is located and how it can best be relaxed using pelvic floor exercises. Advice is also given on stimulating the urination reflex and using the correct posture on the toilet.