What You Should Know About Diabetes And Incontinence

13 December 2017

Like many conditions, having diabetes can lead to a number of additional complications. One of the many issues associated with diabetes is an involuntary or accidental release of urine and faecal matter - commonly referred to as incontinence.

Although the exact reason for the connection between diabetes and incontinence is not yet fully understood, research has shown that certain complications associated with the disease can, in fact, lead to varying levels of incontinence. But to get a better understanding of why this is, it’s worth looking into what diabetes is and how it affects your body.

Diabetes

Diabetes

Diabetes is a worldwide health problem that is rapidly growing in prevalence. According to diabetes.co.uk, the number of people in the UK diagnosed with diabetes is 3.5 million. That's just over 5% of the population, with a predicted increase of 6% by the year 2025. Lifestyle changes, obesity, and an ageing population are some of the main contributing factors to this foreseeable rise in the disease.

What Exactly is Diabetes?

It’s is a long-term disease where the pancreas fails to produce enough of a hormone called insulin (this is called Type 2 diabetes). In some cases, no insulin is produced at all (this is called Type 1 diabetes).

Under normal circumstances, insulin acts as a ‘gatekeeper’ that controls the amount of glucose entering the cells from the bloodstream. Glucose is the source of energy your organs need to function on a daily basis. So, if it isn’t working properly, then an excess amount of glucose is left in the blood which can lead to serious organ damage over time.

Both of these types of diabetes need careful control, either with diet or medication.

Diabetes Complications That Can Lead to Incontinence

There are a number of ways that diabetes can cause urinary and bowel incontinence;

Obesity

Obesity

This is one of the leading factors associated with developing Type 2 diabetes. It also increases your risk of developing incontinence.

Excess weight puts additional strain on your pelvic floor muscles. These muscles support the organs within the pelvis, including the bladder and bowels. When these muscles are not strong enough to provide the support they should, you could notice leaking of urine or faeces - especially when coughing or sneezing. This type of incontinence is commonly known as stress incontinence.

Nerve Damage

If diabetes is not carefully controlled, it can cause damage to the nerve that controls the function of the bladder. This can lead to a loss of sensation which results in little warning when the bladder is full.

In addition, the bladder and bowel might not empty as well as they should due to the nerve damage. This can then lead to urinary tract infections, kidney damage and constipation - which themselves can lead to incontinence.

Uncontrolled diabetes can cause nerve damage in other parts of the body as well. Up to 85% of diabetics with numbness in their hands and/or feet will also have decreased bladder sensation.

Immunity problems

Diabetes can affect the function of your immune system which may result in frequent urinary tract infections (UTI). These infections can, in turn, lead to varying levels of incontinence.

Treatment is with antibiotics as well as strategies to promote bladder emptying. Personal hygiene is important when dealing with infections of the urinary system.

Medication

Some medicine that is used to treat or control Type 2 diabetes can have side effects. One of these is loose bowels (diarrhoea). A combination of weak pelvic floor muscles and other factors associated with incontinence can make the side effects of these medicines worse. Metformin, a medication used to treat Type 2 diabetes, is a common medicine in this category.

If you think the medicine you have been prescribed is causing any level of incontinence, talk to your doctor or continence nurse immediately.

More urine

An increase in thirst is a common side effect of diabetes. This makes you drink more fluids which increases the frequency, asdrinking more water well as the urge to urinate.

High levels of glucose in the bloodstream can also cause an increase in the production of urine. This is because the kidneys are working harder to get rid of the additional glucose by filtering the concentrated blood. This increases frequency of urination, as well as the risk of incontinence.

Mobility Challenges

Diabetes can have serious effects on the body, including chronic pain in the limbs, vision deterioration and even amputation. This can result in people not getting to the toilet on time or struggling to find their way to a toilet. Overflow leakage is the main problem for patients with these sorts of mobility challenges.

Prevention and Treatment

Maintaining healthy blood sugar levels is important in the management of diabetes. By controlling diabetes, you stand a good chance of preventing incontinence. This can be done with a healthy lifestyle which includes a balanced diet, plenty of exercise, and using prescribed medication correctly. A healthy weight will not only decrease the chance of developing incontinence but will also help prevent against Type 2 diabetes as well.

If incontinence remains a problem, pelvic floor exercises (for men and women) and bladder training are an effective way to eliminate the problem. In addition, it might be helpful to practice good toileting habits. This ensures your bladder and bowels stay regular, decreasing the chance of leaking and accidents.

Certain medications that help the bladder relax can also be useful in treating incontinence as they help the bladder hold more urine.

Everyone responds differently to treatment, so always talk to a healthcare professional before taking medication, or attempting any forms treatment.

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