Abstract
ABSTRACTObjective: To determine the prevalence of urinary incontinence (UI) in women with type 2 diabetes mellitus (T2DM) in the North West Bank, Palestine, and to assess the role of potential risk factors including age and DM control.Patients and methods: Adult women with DM attending governmental primary healthcare centres in the North West Bank were interviewed using the Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES) standardised UI questionnaire. The prevalence of UI was estimated and differences between groups were evaluated using the chi-square test. A multivariate logistic model was used to estimate the adjusted relationships and to control for confounders. The statistical significance level was set at P < 0.05. The study was approved by the Institutional Review Board at An-Najah National University.Results: The study included 381 women with T2DM, aged 30–83 years, of whom 43.2% (95% confidence interval [CI] = 37.9–47.8%) reported UI regardless of the type. About 40% reported that they were extremely bothered by the condition and 35.2% stated that their daily routine life was greatly affected. Amongst the women with UI, 133 (80.6%) and 128 (77.6%) were found to have urge and stress UI, respectively. UI was found to be significantly associated with a history of recurrent urinary tract infection (adjusted odds ratio [OR] 3.0, 95% CI 1.9–4.9; P < 0.001) and parity (adjusted OR 1.7, 95% CI 1.1–2.7; P = 0.04)Conclusions: The prevalence of UI amongst Palestinian women with T2DM regardless of the type is high. The findings highlight the importance of educating women with T2DM about UI. The medical team should focus on this problem as it is often neglected; physicians should be alert for UI as it is often underreported and therefore undertreated.Abbreviations: BMI: body mass index; (T2)DM: (type 2) diabetes mellitus; HbA1c: haemoglobin A1c; MoH: Ministry of Health; NHANES: National Health and Nutrition Examination Survey; OR: odds ratio; QoL: quality of life; (S)(U)UI: (stress) (urge) urinary incontinence.
Highlights
Diabetes mellitus (DM) is one of the most common chronic medical illnesses worldwide, with rising incidence and prevalence [1]
Of the 400 North West Bank (Palestine) female diabetic patients who were invited to participate in the study, 19 of them refused to be involved as they justified that they had no time for the interview or felt embarrassed to talk about urinary incontinence (UI)
Evidence has shown that diabetic women are at 50–200% greater risk of developing UI compared to women with normal glucose levels [12]
Summary
Diabetes mellitus (DM) is one of the most common chronic medical illnesses worldwide, with rising incidence and prevalence [1]. DM can lead to important microvascular and macrovascular complications; such as cardiovascular diseases, neuropathy, retinopathy, and nephropathy. Recent estimates show that by 2025 women with type 2 DM (T2DM) will represent the highest percentage of the diabetic population [2]. Urinary incontinence (UI) remains a highly prevalent cross-cultural and costly condition that affects women of all ages. In the Middle East, 20–60% of women complain of UI [3,4]. The ICS defines UI as ‘the complaint of any involuntary leakage of urine’ [5]. It was predicted that 423 million individuals would suffer from UI by the year 2018 worldwide
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