1580 ARE LOWER URINARY TRACT SYMPTOMS IN WOMEN WITH TYPE 2 DIABETES AFFECTED BY GLYCEMIC CONTROL?

Abstract

INTRODUCTION AND OBJECTIVES: It is well-known that intensive glycemic control defined as hemoglobin A1c (HbA1c) 6.5% is able to reduce diabetes-associated microvascular and macrovascular complications. However, it remains unclear whether glycemic control is associated with lower urinary tract symptoms (LUTS) and functions in women with type 2 diabetes. This study aimed to clarify this issue. METHODS: A total of 400 Taiwanese women with type 2 diabetes aged 48 to 75 years were included in this study. To examine the impact of HbA1c, patients were divided into tertiles according to the average of three consecutive HbA1c measurements in the past year. The lower urinary tract symptoms and functions were evaluated with the American Urological Association Symptom Index (AUA-SI) questionnaire and uroflowmetry (UFM) including voided volume (VV), peak urinary flow rate (Qmax) and the post void residual (PVR), respectively. RESULTS: The mean HbA1c was 6.2% (range, 5.6-6.7%, n 132) for tertile 1, 7.1% (6.8-7.4%, n 132) for tertile 2, and 8.4% (7.5-14.2%, n 136) for tertile 3. The overall prevalence of LUTS was 34% which defined as AUA-SI score more or equal than 8. However, no significant differences were found among tertiles 1, 2 and 3 regarding the patient’s age, storage, voiding and total AUA-SI scores. UFM parameters including VV and Qmax were also similar between groups. Of note, patients with the worst glycemic control had significantly higher PVR (p 0.01) and severe LUTS (Table1). Multivariate analysis revealed age, nephropathy and the presence of diabetic neuropathy were the independent factors to predict the presence of LUTS in women with type 2 diabetes. CONCLUSIONS: A significant higher PVR and severe LUTS were found among patients with the worst glycemic control. However, glycemic control in terms of HbA1c was not significantly associated with the development of LUTS.