The Link Between Diabetes And Incontinence

Diabetes is one of the most common chronic conditions in the world, but many people are unaware of how it impacts more than just blood sugar. One of its lesser-discussed complications is its effect on the bladder. 

In this blog, we’ll explore the science behind the connection between the two, including the different types of incontinence linked to diabetes and how you can help manage it.

Chronically high blood sugar damages nerves throughout the body, and that includes those that control the bladder.

It’s a condition called neurogenic bladder, which can make it hard to sense when the bladder is full and contract the bladder when weeing.

Because of this, it can eventually lead to the inability to fully empty the bladder, and an underactive or “atonic” bladder in some cases.

• Reduced bladder sensation
• Incomplete bladder sensation
• Higher risk of infections from stagnant urine

Type 2 diabetes is usually associated with obesity, which adds physical strain to the bladder and pelvic floor.

This is because extra weight around the abdomen increases pressure on the bladder and weakens the muscles around it.

• Increased abdominal pressure can cause leaks
• Pelvic floor strain weakens control
• Higher BMI increases the risk of stress incontinence by up to 85%

People with diabetes are more likely to develop UTIs, as explained in a National Library of Medicine report.

High sugar levels in your urine can create grounds for bacteria, with impaired immunity making it harder to fight off infections. 

This can become worse and more frequent if you’re not able to fully empty your bladder regularly.

• Frequent UTIs increase urgency and frequency
• Bacterial growth in glucose-rich urine
• Nerve damage makes it harder to clear infections fully

Even without nerve damage or infections, high blood sugar on its own can create bladder issues.

When glucose levels rise, the body tries to flush it out through your wee, which can result in excessive urination (polyuria) and increased thirst. 

Then you drink more fluids because of the thirst, and you can end up in a cycle of trips to the bathroom and leaks.

• Excess weeing from glucose flushing
• Larger fluid intake increases urgency
• Osmotic diuresis (when the kidneys excrete high amounts of wee due to certain substances in the fluid being filtered, like glucose in diabetes cases) adds to bladder strain

Diabetes can trigger almost any of the different types of incontinence, it depends on what it’s affecting the most.

Urge incontinence is common when the bladder nerves become overactive, while overflow incontinence develops when the bladder can’t empty fully.

Stress usually appears in those who are overweight, and mixed incontinence combines two or more of these types.

In some instances, functional incontinence arises because of muscle weakness or nerve problems, making it hard to reach the toilet in time.

• Urge incontinence: sudden and overwhelming need to wee. This is often caused by an overactive bladder that contracts unexpectedly. This condition may lead to large urine leaks before reaching a toilet and is frequently associated with triggers like the sound of running water.
• Overflow incontinence: leakage from incomplete bladder emptying, which is often caused by diabetic nerve damage or obstruction. Essentially, the bladder becomes overfilled and then leaks without warning. 
• Stress incontinence: leakage during coughing, laughing, or exercise. It’s usually linked to weakened pelvic floor muscles, which can be strained by obesity and pregnancy. Over time, this type of incontinence can make people want to avoid exercise and physical activity.
• Mixed incontinence: combination of stress and urge symptoms. People might leak because of sudden urgency and pressure on the bladder.  
• Functional incontinence: difficulty reaching the toilet due to physical (e.g. arthritis, joint pain), mobility (e.g. recovering from hip surgery, reliance on a walking frame) or neurological complications (e.g. diabetic neuropathy, Parkinson’s disease). The bladder actually functions perfectly well normally — it’s the delay of getting to the toilet that causes the leaks.

For more information on the four main types of incontinence, check out our complete guide here.

The good news is that incontinence linked to diabetes can often be prevented, managed, and significantly improved. Like we said, we’re here to help.

With a combination of medical care, some lifestyle changes, and proactive management, you can stay ahead of your incontinence.

Keeping blood glucose levels within target ranges is one of the most effective ways to reduce the risk of bladder problems.

Good control can delay or prevent the nerve damage that often leads to incontinence.

It’s always beneficial to get professional health advice on managing blood sugar, however, some methods include following a balanced diet and monitoring blood sugar levels regularly with a glucose meter. 

Obviously, it’s also vital that you take any medication or insulin prescribed by your doctor.

Even small amounts of weight loss can make a huge difference in improving your bladder control.

One study shows that losing just 5–10% of body weight can reduce instances of incontinence, because it eases pressure on the bladder and pelvic floor. 

Losing excess weight can improve any strain on surrounding muscles and nerves that control your weeing, and even improve insulin sensitivity and make diabetes easier to manage.

Simple changes in your day-to-day can also help.

Staying hydrated with water rather than sugary drinks, cutting back on caffeine and alcohol, and doing regular exercise all support bladder health. 

Pelvic floor exercises like Kegels can strengthen those bladder muscles.

For some people, retraining the bladder is another method. This could involve going to the bathroom on a schedule and then gradually increasing the time between trips.

Although this might not be effective if you’re suffering from severe nerve damage, it can help build control for many. 

What this aims to do is “reset” the signals between the bladder and your brain, teaching the bladder to hold your wee for longer.

Because using your bladder involves muscles and nerves, consistent training can strengthen this brain-bladder connection, helping your brain become better aware of when it is full.

This should always be the first port of call.

Doctors can help by screening for infections, adjusting medications, and prescribing treatments for bladder overactivity. 

You can also manage symptoms with protection from incontinence products like incontinence pads, disposable incontinence pants, and disposable adult nappies. 

Incontinence shouldn’t just be dismissed as “part of diabetes”.

If you notice sudden changes in your weeing habits, begin to experience frequent UTIs, or feel like you’re not able to fully empty your bladder, then it’s important that you speak to a healthcare professional.

These symptoms could indicate early complications that can become worse if they’re not dealt with, so we suggest you get medical support as soon as you can.