The Relationship Between Diabetes, Diabetes Severity, Diabetes Biomarkers, and the Presence of Lower Urinary Tract Symptoms: Findings From the National Health and Nutrition Examination Survey

Abstract

To characterize the associations between diabetes mellitus (DM) and lower urinary tract symptoms (LUTS). This study focuses on the relationships between specific diabetic characteristics (eg, severity, biomarkers) and the prevalence of LUTS. The 2005-2008 cycles of the National Health and Nutrition Examination Survey were queried for men who completed both a DM and a kidney/prostate questionnaire. Men with LUTS were defined as those experiencing at least 1 out of 3 of the following: nocturia, hesitancy, or incomplete emptying. Men with DM were defined as having been diagnosed by a physician and being actively treated. Multivariate logistic regression with sample weighting was performed to assess effects of biomarker levels (HgbA1c, fasting glucose), medication use, and surrogates of disease progression on the presence of LUTS. Of the 2127 male participants, those with DM (n = 405) were more likely to experience at least 1 urinary symptom (adjusted odds ratio 1.63, P <.0001). Men under the age of 70 with long-standing (>5 years) DM were more likely to report LUTS than those with a shorter duration of the disease (<5 years). Diabetes-specific biomarkers (HgbA1c, fasting glucose) were not predictors of LUTS in men with DM. DM was confirmed to be strongly associated with patient-reported LUTS in men. Younger men and those with longer-standing disease appear to be most susceptible. In actively treated patients with DM, DM biomarkers were not helpful in predicting individual LUTS. Instead, biomarkers that indirectly reflect DM disease progression were most useful.