Diabetes and Incontinence: Is There A Connection?

The link between diabetes and incontinence is a good reason to remind patients to monitor blood sugar levels.

According to the National Institutes of Health (NIH) “about 50 percent of patients with diabetes also suffer some type of nerve damage due to decreased blood flow and high blood sugar levels.”¹ This nerve damage is called “diabetic neuropathy”. Among other consequences, diabetic neuropathy can affect bowel/bladder function leading to incontinence. Since treatment to reverse nerve damage is often not possible, care is focused on managing symptoms and preventing further problems. All the more reason to encourage patients with diabetes or the potential for the disease to closely monitor blood sugar levels.

What causes diabetic neuropathies? The causes are different for different types of diabetic neuropathy. The National Diabetes Information Clearinghouse (NDIC) notes the type of neuropathy that affects incontinence is termed “autonomic” since it damages nerves that carry information from the brain to various organs, including the bladder.²

Symptoms include: 1) difficulty in beginning to urinate, 2) feeling the bladder is not emptying completely, and 3) leakage problems.

Researchers continue to study how prolonged exposure to high blood glucose causes nerve damage, which is likely due to a combination of factors:

• metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
• neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
• autoimmune factors that cause inflammation in nerves
• mechanical injury to nerves, such as carpal tunnel syndrome
• inherited traits that increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use.²

The first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Blood glucose monitoring, meal planning, physical activity, and diabetes medicines or insulin all help control blood glucose levels. As scientists learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent, or even reverse nerve damage.²

For your patients or loved ones with incontinence, recommend that they try to urinate at regular intervals (every 3 hours, for example) because they may not be able to tell when the bladder is full.² Also encourage them to follow all their normal incontinence precautions. And remind them that HDIS offers a full range of products for incontinence care.

¹ U.S. National Library of Medicine (NLM) National Institutes of Health (NIH) “Diabetes and Nerve Damage” Last Update: May 28, 2013. https://medlineplus.gov/ency/article/000693.htm

² National Diabetes Information Clearinghouse (NDIC) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) “Diabetic Neuropathies: The Nerve Damage of Diabetes” Last Update: November 26, 2013. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/#what