People with diabetes can experience challenges with controlling their bladder and bowel. This can involve accidental leakage of urine, incomplete emptying of the bladder, passing urine frequently (frequency) or feeling the need to rush to the toilet (urge). There are three types of Diabetes, Type 1, Type 2 and Gestational Diabetes which is diabetes that develops during pregnancy. Although the causes and treatments for the types of diabetes can be different the complications or damage to the organs of the body resulting from a high blood glucose levels are similar. There are four main ways that diabetes may cause problems with bladder and bowel control:
Obesity is a major factor in people developing Diabetes. It is also a major risk factor for developing bladder and bowel control problems. The pelvic floor muscles support most of your body weight. Any excess weight further strains these muscles, weakening them. Weak pelvic floor muscles do not support the bladder the way it should. If this happens you may notice leakage when coughing and sneezing (also known as stress incontinence) or the need to frequently or urgently visit the toilet.
People with diabetes can, over time, develop nerve damage throughout the body including the urinary tract causing problems in passing urine. This nerve damage is call Diabetic Neuropathy. The highest rate of nerve damage are in people with long-term diabetes or who have problem controlling their blood glucose, also called blood sugar.
The nerve damage can prevent the bladder from emptying completely, allowing bacteria to grow in the bladder and kidneys causing urinary tract infections. Urinary incontinence may result when the nerves of the bladder are damaged because the person may not be able to sense when the bladder is full or have control over the muscles that release urine.
Diabetes can also have an effect on the function of the immune system putting you at greater risk to infections. A common infection experienced by people with diabetes is urinary tract infection (UTI). It is the combination of the immune system changes and the poor bladder emptying that causes these infections and often they keep reoccurring. Treatment includes antibiotics and strategies to promote bladder emptying. In addition personal hygiene is particularly important and all women should wipe from front to back to avoid transferring bowel bacteria to the vagina.
Some of the medications used to control diabetes may cause loose bowel actions (diarrhoea). The combination of weak pelvic floor muscles and loose bowel actions may cause bowel incontinence. If you are experiencing these problems talk to your Doctor, Dietician or Diabetes Nurse Educator.
Atnip, S. (2014). About Incontinence – Contributing Factors – Diabetes. Retrieved from www.simonfoundation.org/About_Incontinence_Contributing_Factors_Diabetes.html