The Link Between Diabetes and Incontinence

There are four main ways in which diabetes relates to urinary incontinence.

One is diabetic neuropathy, or nerve damage. Untreated or long-term diabetes causes nerve damage throughout the body. In fact, about 60% of people with diabetes have some form of neuropathy, perhaps best known to occur in the feet. Well, this can happen at the bladder too. When it happens to the nerves around the urinary tract, it’s known as a ‘neurogenic bladder’. The result can be urinary leaking, urine retention, overactive bladder, underactive bladder, increased nighttime voiding, or the inability to tell when you need to go. Constipation in a diabetic may also be a result of diabetic nerve damage, and this also increases the risk of urinary incontinence.

Constipation means more strain on the pelvic floor, and over time, that can lead to pelvic muscle dysfunction and a resultant lack of support for the bowel and bladder. Additionally, constipation means that more space is taken up in the abdominal cavity, leaving less room for the bladder to fill. So urgency and/or leaking are more likely.

About 90% of those with Type 2 diabetes are medically overweight or obese (and Type 2 diabetes accounts for the majority of all diabetes cases). Obesity comes with a higher risk of stress urinary incontinence. The increased weight puts more pressure on the bladder and pelvic floor, making it more difficult to maintain adequate support for continence.

Diabetes causes a lowered immune system response, so there is a greater risk for urinary tract infections (UTIs). UTI symptoms include bladder urgency, frequency, and incontinence. Repeat UTIs can also eventually cause bladder damage, which may exacerbate incontinence. In fact, a history of recurrent UTIs is the main risk factor and predictor of urinary incontinence in diabetic women.

Lastly, some diabetes medications cause side effects to the bowels or bladder, like diarrhea and urinary urgency. There is a higher risk of urinary leaking with such side effects. If side effects are too severe, alternative medications or additional medications to treat side effects may be available from your physician.

Possible solutions for incontinence with diabetes range from medical interventions to lifestyle changes. In the case of medications, a UTI, and neuropathy, a medical treatment from your physician may be warranted. Otherwise, lifestyle changes that can help manage incontinence include:

- Weight loss / Maintaining a healthy weight
- Pelvic floor (kegel) exercises
- Wearing a pessary to support the bladder
- Maintaining a bladder schedule
- Dietary options to prevent constipation
- And other custom tips to improve bladder voiding, frequency, and urgency

If you are a person living with diabetes and incontinence, we encourage you to speak with your medical provider(s) about potential medical, nutritional, exercise, and/or lifestyle support for your symptoms. You are not alone!

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​** Note: this content serves as educational only. It does not constitute medical evaluation, treatment, or advice. Please consult with your medical provider(s) as needed, before partaking in changes to your medical, fitness, or health care practices.