Are those constant trips to the bathroom just another unpleasantry of diabetes, or a symptom of OAB? Due to the constant thirst and increased urination that often results from diabetes, it can be easy to miss signs of a bladder condition. In fact, researchers have found that diabetics over a certain age are twice as likely to develop OAB than those without diabetes, and many go years before ever realizing they have an overactive bladder.
With diabetes, your system is working overtime trying to expel the excess glucose in your blood, which causes more frequent urination and dehydration. Many people think this process is what causes the link between diabetes and OAB. However, studies present an alternative conclusion.
Type 1: While less than 5 percent of people with diabetes have type 1, it is still a widespread condition that affects people of every age, race and gender. Formerly known as juvenile diabetes because of its diagnosis early in life, type 1 diabetes is an autoimmune disorder in which the body cannot produce insulin, a hormone necessary for regulating blood sugar. Because of this, people with type 1 diabetes are unable to turn sugar into energy.
Type 2: Type 2 diabetes is the most common form of diabetes and typically shows up later in life. This condition causes blood sugar levels to rise higher than normal, also called hyperglycemia. Type 2 diabetes prevents your body from creating enough insulin, so it cannot keep blood sugar at safe, normal levels. According to a recent study, over 400 million people suffer from type 2 diabetes worldwide, and the numbers are only growing.
Pre-diabetes: While not an actual form of diabetes, pre-diabetes occurs when the body’s blood sugar levels are abnormally high but not yet in the diabetic range. This condition comes with its own health risks and should be seen as a wake-up call to those who suffer from it. In a 2015 study, it was estimated that 33.9 percent of U.S. adults had pre-diabetes, and while the condition is not reversible, it is possible to prevent pre-diabetes from evolving into type 2 diabetes.
What is OAB?
Overactive Bladder Syndrome is a condition that causes the sudden and uncontrollable urge to urinate. This is a common condition, affecting 1 in 5 adults over the age of 40. These urges can happen whether the bladder is full or not and can cause notable distress to those who suffer from it. The first symptom of OAB is feeling the urge to urinate more than eight times per day, and if urges come when the bladder is full, it can lead to minor leakage.
Nocturia is a form of OAB that occurs only at night and can cause people with the condition to lose sleep due to constant trips to the restroom. It can also cause accidents in bed and a lower quality of life due to a consistent lack of sleep. In elderly patients, it can also lead to an increased fall risk and resulting injuries from nighttime bathroom trips in the dark.
Study Shows Diabetes Linked to OAB
Renal and Urology News published the results of a 2011 study that examined the prevalence of OAB among diabetics. Researchers analyzed a group of 1,359 men and women with type 2 diabetes and found significant OAB association in over one-fifth of the participants. The occurrence of OAB was higher in men than in women, and the study also noted that patients over the age of 50 and those who had been suffering from diabetes for more than 10 years were twice as likely to have OAB.
A cohort of researchers based in Japan were the first to discover this link. According to the study, because of high blood sugar levels, nerves can be damaged throughout the entire body, including the bladder. This may lead to signals being sent to the bladder at irregular and inappropriate times, causing frequent and sudden urges to urinate.
The authors of the study say they hope the findings will inspire a collaboration between urologists and diabetologists when it comes to developing screenings and treatments for people who are at an increased risk for complications.
Can Pre-diabetes Also Contribute to OAB?
In a more recent study published in August of 2018, researchers found an increased risk for OAB in women with pre-diabetes. This study focused on how elevated fasting plasma glucose (FPG) and high blood sugar can be independently linked to a higher risk of OAB by monitoring 2,298 men and 3,473 women at a median age of 65. The participants were given detailed health evaluations and were asked standardized questions for OAB screenings. From those studies, 11.8 percent of women and 8.2 percent of men reported symptoms of OAB.
These findings show, “even modestly elevated fasting plasma glucose (FPG) and HbA1c are independently associated with an increased likelihood of OAB in women.” As a result, pre-diabetes may affect women’s bladder storage function, while no significant link appears in men.
Is Diabetes Linked to Other Urologic Conditions?
While overactive bladder syndrome is common among those with diabetes, it is not the only urologic issue that can arise. Melissa Conrad Stöppler, MD states that diabetes can lead to a number of different urologic issues due to damaged blood cells and nerves throughout the body, particularly in the bladder and urethra. In addition to overactive bladder, urologic conditions people with diabetes may suffer from include:
- Urinary tract infections
- Urine retention
- Sphincter muscle damage
Urologic issues are not the only potential problems diabetics face due to their nerve and blood vessel damage. Proper nerve / muscle control and blood flow are essential components in sexual function, so if something is obstructing their communication, it can lead to dysfunction. Sexual problems for both men and women that can result from diabetes include:
- erectile dysfunction
- retrograde ejaculation
- vaginal dryness
- painful intercourse
- decreased or absent sexual response / desire
Those who suffer from diabetes may be at a higher risk of sexual and urologic issues if they are overweight, smoke, have high blood pressure, high cholesterol, are over 40, or have a sedentary lifestyle. Therefore, people with diabetes can lower their risk of these problems by controlling blood sugar, blood pressure and cholesterol levels. Staying active, maintaining a healthy weight and quitting smoking can also lower the risk. Once these problems arise, it is important to visit a urologist or gynecologist to discuss the symptoms and treatment options.