Urologic Complications of Diabetes Common, Often Unaddressed

Allison Shelley

June 13, 2016

 

Patients with diabetes often experience urologic complications that they might not talk about but that could escalate and even worsen glucose control.

Difficulties with bladder and sexual function can amplify physical and social isolation, increase weight gain, and intensify depression, meeting attendees heard during a session at the American Diabetes Association 76th Scientific Sessions in New Orleans that was so popular an overflow room was needed to accommodate the large audience.

Understandably, blood health is the focus of management for patients with diabetes, said presenter Tamara Bavendam, MD, from the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland. "But physicians need to be proactive and find out more."

Most patients with diabetes "aren't going to tell you their bladder is bothering them, and women in particular are less likely to discuss it," Dr Bavendam told Medscape Medical News before her talk.

Urologic complications can impede social activities and hinder diabetic outcomes. "If a woman is running to the bathroom all the time, she's less likely to want to go for a long walk," said Dr Bavendam. "If she's wetting herself, she's probably stressed and thinking about what will happen when she's in public, so she's less likely to be physically active at all, and she may gain weight and have trouble managing her diabetes."

 
If a woman is running to the bathroom all the time, she's less likely to want to go for a long walk. If she's wetting herself, she's probably stressed.
 

"There aren't good data on some of these issues," she explained. "I've noticed that women who are incontinent are more likely to wear pads, which grow bacteria and might increase their risk for infection," she told Medscape Medical News. "It just doesn't seem like a good idea."

But with the right resources, patients can ease urologic complications and improve diabetic outcomes on their own, she added.

Session chair Christian Winters, MD, from the Department of Urology at Louisiana State University in New Orleans said one of the biggest problems he sees in patients with diabetes in his practice is urinary sepsis after kidney stone procedures.

"There are a number of well-identified factors that can lead to these complications," he pointed out, but "treatments are available."

"The big concern for patients with diabetes is the risk for kidney infection," Dr Bavendam added. "The tendency is to treat, but with growing rates of antibiotic resistance, the trend is to make sure that patients really need the antibiotics."

Physicians need to come together to help these patients, she said.

For more information, see Urinary Incontinence and Overactive Bladder News and Perspectives on Medscape.

Dr Bavendam and Dr Winters have disclosed no relevant financial relationships.

American Diabetes Association (ADA) 76th Scientific Sessions: Session 1-AC-MS04. Presented June 10, 2016.

Follow Allison Shelley on Twitter: @allishelley

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