Lifestyle changes may improve bladder control in women

Losing a modest amount of weight through dietary changes and increased activity reduces the occurrence of urinary incontinence in women with prediabetes, according to a recent study published in Diabetes Care (2006; 29:385-90).

The study randomly assigned 3,234 overweight women with higher-than-normal blood glucose levels to one of three approaches to prevent type 2 diabetes. Women who implemented intensive lifestyle changes and lost 5% to 7% of their weight had fewer episodes of weekly incontinence compared with those in drug therapy or placebo groups (38% vs. 48% vs. 46%, respectively).

Weight loss was particularly effective in reducing episodes of stress incontinence, but there was no alleviation of urge incontinence, according to the authors, led by Jeannette S. Brown, MD, of the University of California, San Francisco.

Separately, Harvard Medical School researchers evaluating the association between type 2 diabetes and the development of urinary incontinence found that the risk of prevalent incontinence and incident incontinence was significantly greater in women with diabetes than in women without it. Using a validated severity index, risk of developing severe incontinence was even more substantial in women with diabetes (multivariate relative risk=1.40, 95% CI=1.15 to 1.71 for leakage enough to wet the underwear; RR=1.97, 95% CI=1.24 to 3.12 for leakage enough to wet the outer clothing).

In addition, risk of incontinence increased with duration of diabetes, according to the study, published in the Journal of the American Geriatrics Society (2005; 53:1851-7).