Diabetes-related incontinence may be preventable

Overweight women with diabetes can cut their risk of developing urinary incontinence (UI) by shedding 5% to 10% of their body weight or as little as 15 lbs (7.7 kg), according to findings from the Look AHEAD trial, a multicenter, randomized, controlled trial of overweight and obese individuals with type 2 diabetes.

The trial, published online January 18 in the Journal of Urology, involved 2,739 women, 45 to 76 years of age, with body mass indices (BMI) of 25 kg/m² or greater. The women were stratified into 2 groups. The first received intensive lifestyle intervention and modification counseling designed to promote weight loss of at least 7% per year. Professionals encouraged the women to consume low calorie, low fat diets, to control portions with liquid meal replacements, and to exercise at least 175 minutes per week. The women checked in weekly for 6 months and then 3 times monthly for another 6 months.

The second group received far more limited diabetes support and education: In 1 year, they attended only 3 group sessions that focused on diet, physical activity, and social support.

At 1 year, women who lost the weight were 25% less likely to develop UI in general and 40% less likely to have stress UI. Each kilogram of weight lost reduced the odds of developing UI by 3% (P=0.01). Weight losses of 5% to 10% reduced the odds by almost half (47%; P=0.002).

The study did not show that weight loss improved resolution rates of UI at 1 year. “It is possible that weight loss is more effective for the prevention than for the treatment of UI in women who already have type 2 diabetes,” concluded the authors. However, only about one-quarter of the women had UI at study entry. Future research should recruit women with UI and type 2 diabetes and use detailed assessments to document specific changes in their condition, the authors suggest.

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