Diabetes and Incontinence – Why and How to Treat it

Pelvic Floor Health | | INTIMINA
6 min read

This article was medically fact-checked by Consultant Obstetrician and Gynaecologist Dr. Shree Datta.

Approximately 13 million American women have diabetes and they experience many challenges, but one of the more inconvenient side effects is an increased risk of urinary incontinence. Even though women with diabetes have up to a 70% increased risk of developing incontinence, it remains one of the more difficult topics for women to discuss, so many suffer in silence – but you don’t have to!

The first step to reducing frequent urination is to work with your doctor to get your blood sugar under control and understand how diabetes is affecting your body. This requires seeking early expert advice, but there are also simple solutions you can start right now to get relief and reduce how often the urge strikes.

How Diabetes Can Lead To Incontinence

First, it’s important to understand the ways diabetes contributes to incontinence.

  • Blood sugar. Regardless of whether you have type 1 or type 2 diabetes, your blood has an excess amount of glucose, or sugar, in it. The excess blood sugar impacts kidney function and pulls fluid from your tissues, making you feel thirsty and causing you to drink more – which leads to more urination.

  • Obesity. Up to 90 percent of patients with type 2 diabetes are also considered to be obese.  Alongside many other challenges, being overweight and obese can also contribute to weaker bladder control because it puts pressure on your bladder and your pelvic floor.
  • Excess weight on your pelvic floor makes it more difficult for these muscles to support your bladder and your urethra, leading to leaks. Managing weight loss through healthy lifestyle changes can potentially help with urinary incontinence. 
  • Decreased feeling. Diabetes can lead to damage to the autonomic nerve system, which controls the internal organs and bodily functions we don’t consciously control. Damaged nerves can lead to decreased feeling in or send the wrong signals to the bladder, so you can sometimes have that “I need to go!” feeling either too late or too often.
  • UTI’s. Diabetes can also interfere with the immune system, putting you at greater risk of urinary tract infections or UTI’s. UTI’s can cause pain and an intense, sudden need to urinate. Fortunately, they’re treatable, but women with diabetes tend to have an increased likelihood of repeated infections. Staying well hydrated helps to prevent UTI’s, as does completely emptying the bladder when peeing – this is called complete voiding.

  • Medication. Unfortunately, some medications prescribed to those with diabetes can sometimes cause issues with urination. Ask your provider to review any medications you’re on, to help treat urinary symptoms. 

How You Can Manage Frequent Urination

Work with your doctor to control your diabetes

One of the best ways of managing diabetes-related incontinence is to work closely with your doctor to control your blood sugar and find medications and dosages that will work best for your body and avoid leaks. But in the meantime: do not restrict your water-intake. It’s very important to stay hydrated, especially if you have diabetes.

You might worry it will increase leaks, but your body needs water to replenish your bodily fluids, and drinking less water may irritate your bladder and make incontinence worse. It may also be helpful to change what you’re eating and drinking, as some foods are linked to incontinence.

For example, alcohol and caffeine are natural diuretics, which can stimulate the need to urinate.

If you’re not ready to cut out caffeine, try just drinking it in the morning, while buffering it with hydrating liquids. 

While working with your doctor to tackle the underlying issues with diabetes you can also start managing your bladder issues directly.  For best results, talk to your doctor about the different options to see what works best with your treatment.

Strengthen your pelvic floor with Kegel exercises 

Help your pelvic floor help you! Exercising your pelvic floor regularly using Kegel exercises helps build up the strength of those muscles that might have been strained by additional weight gain caused by diabetes.

A stronger pelvic floor will help support your bladder and give you better control when you feel the urge. But it’s important to make sure you’re doing each exercise properly so check out this article to ensure you have proper technique.

Once you know how to do a proper Kegel it’s important to make sure you’re doing the right routine for you every time you exercise. The best way to ensure that you’re getting the most out of your routine is to use a smart Kegel exerciser.

The best exercisers not only register your pelvic strength throughout each session, but also automatically select and guide you through a routine tailored to your strength level. That way you know that you are getting the best possible workout for your particular needs.

Seeing a physiotherapist can also help you in strengthening your pelvic floor, and urinary muscles. Physiotherapists are like personal trainers for your pelvic floor! They may ask you to keep a symptom diary to track your progress, although this is something you can do on your own as well. 

Retrain your bladder to restore proper function.

You can help your bladder “relearn” its normal function by scheduling bathroom visits at regular intervals throughout the day – this is called bladder training. You can start with scheduling visits a short time apart and gradually increase the time between as your body becomes accustomed to waiting. Don’t worry if you leak a bit between visits – your body has to learn your new schedule, and it might take some time.

Suppress the urge to urinate with simple exercises 

While you’re retraining your bladder, you can use urge suppression exercises to regain control and manage the sudden, urgent need to urinate. When you feel the need to urinate, remain still, breathe deeply and contract and relax your pelvic floor muscles rapidly a few times. At the same time, find something to do to distract yourself, such as checking your Facebook, sorting your inbox, or texting.

Incontinence can be irritating, embarrassing and inconvenient, but it’s important to remember that many women are facing the same issue. These solutions are a great way to start managing your urination issues but in the long term, the most important thing you can do to reduce incontinence is manage your blood sugar levels. 

Keeping blood glucose in check will not only reduce the frequency and severity of incontinence but many of the other complications associated with diabetes as well. With some simple exercises and support from your physicians and loved ones, you can conquer incontinence and the other symptoms of diabetes, and live a healthy, active life.

Facts checked by:

Dr. Shree Datta

Dr. Shree Datta

Dr. Shree Datta is a Consultant Obstetrician and Gynaecologist in London, specialising in women’s health including all menstrual problems such as fibroids and endometriosis. Dr. Shree is a keen advocate for patient choice, having written numerous articles and books to promote patient and clinician information. Her vision resonates with INTIMINA, with the common goals of demystifying periods and delivering the best possible care to her patients

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