WASHINGTON — Obese female patients should be screened for urinary incontinence, particularly if they have diabetes, Jean M. Lawrence, Sc.D., reported in a poster at the annual scientific sessions of the American Diabetes Association.
A community-based survey of 4,237 women aged 25–84 years revealed significantly increased rates of three major forms of incontinence among women who were obese and had diabetes, reported Dr. Lawrence, of Kaiser Permanente Southern California, Pasadena, and her associates.
The women had a median age of 58 years. They were 60% white, 20% Hispanic, 10% black, 8% Asian, and 2% race unknown. Overall, 15% had stress urinary incontinence (SUI), 13% had overactive bladder (OAB), and 25% had anal incontinence (AI). In addition, 11% had diabetes, of whom 21% used insulin. The women with diabetes were older (64.6 years vs. 56.1 years), were more likely to be menopausal (85.8% vs. 64.4%), and to be obese (54.9% vs. 23.8%).
Of the 472 women with diabetes, 23.2% had SUI, compared with 14.1% of the 3,765 women without diabetes. OAB was also significantly more common among those with diabetes (21.6% vs. 12.4%), as was AI (32.4% vs. 24.3%).
Women who were both obese and had diabetes had adjusted odds ratios of 3.2 for SUI, 3.1 for OAB, and 1.8 for AI, compared with women who did not have either condition. Women who were obese but did not have diabetes had the next highest risk, with odds ratios of 2.45 for SUI, 2.79 for OAB, and 1.45 for AI. Among the nonobese women with diabetes (both insulin users and nonusers), the only significantly elevated risk was for SUI, with an odds ratio of 1.55, Dr. Lawrence and her associates reported.