We associate Diabetes with high blood sugar, nerve problems and Kidney Disease. However, did you know that incontinence is another possible complication of Diabetes?
Bladder control problems caused by a neurological condition is known as neurogenic bladder. In individuals with Diabetes, incontinence can be a progressive condition, causing both day time and night time leakage.
Why Does Diabetes Cause a Higher Incontinence Risk?
One of the most common complications of Diabetes is nerve damage, or neuropathy, which is caused by high blood sugar levels. Your body has a network of autonomic nerves that run from your heart to your bladder. Our nervous system has four main parts, which include the cranial, central, peripheral and autonomic nerves. Urogynecology Nurse Practitioner Shanna Atnip explains, “Diabetes often damages the peripheral, autonomic, and cranial nerves. The autonomic nerves go from your spinal cord to your lungs, heart, stomach, intestines, bladder, and sex organs”. Nerves in the bladder and bowel can therefore be affected by Diabetic Neuropathy, resulting in problems with bladder and bowel control. These problems can include decreased bladder sensation, weak bladder muscles and an overactive bladder (leading to urge incontinence).
Diabetic neuropathy can also affect the hands and legs, which can contribute towards incontinence, as people may have trouble making it to the bathroom quickly enough. Neuropathy can be bilateral or affect individual nerves. For example, common peroneal damage causes foot drop. This is a muscular weakness that makes it difficult to lift the front part of your foot and toes, resulting on the foot dragging on the floor when they walk.
The Prevalence of Obesity in Type 2 Diabetes
If you are overweight or obese, you are at greater risk of developing type 2 Diabetes. This is particularly relevant if you carry excess weight around your stomach. Abdominal fat can cause fat cells to release “pro-inflammatory” chemicals. This makes the body less sensitive to insulin it produces, due to disruption to the function of insulin responsive cells. It is estimated that each 5-unit increase in body mass index is associated with an incontinence prevalence risk of up to 50%. Carrying excess weight causes stress to placed on the pelvic floor muscles. This can be compared to a woman in the later stages of pregnancy, in which leaks are common. High body weight can also increase abdominal pressure, which increases bladder pressure and urethral mobility.
A 5% reduction in body weight followed up by regular moderate intensity exercise could reduce your type 2 Diabetes risk by more than 50%
A Weak Immune System
In individuals with type 2 Diabetes, individuals do not produce enough insulin or it does not use it right away. This is called insulin resistance. Both of these types can severely lower the actions of the immune system. Individuals with Diabetes can often be more prone to sickness bladder infections, which can cause urge incontinence.
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What are the Different Types of Incontinence?
- Stress incontinence: this occurs when pressure placed on the bladder causes involuntary leakage
- Urge incontinence: the loss of urine associated with a sudden, strong desire to urinate
- Overflow incontinence: this occurs when the bladder doesn’t empty properly, causing urine to leak out in unwanted circumstances
- Functional incontinence: this occurs when a person is unable to get a bathroom due to physical or mental reasons
- Transient incontinence: a type of incontinence caused by an illness or temporary problem that is short-lived
- Nocturnal Enuresis: involuntary urination that happens at night during sleep, after the age when a person should be able to control their bladder
- Faecal Incontinence: an inability to control bowel movements, resulting in involuntary soiling