Diabetes explained
About 537 million adults between the age of 20-79 years worldwide are living with diabetes, and the prevalence has steadily increased over the years. The total number of people living with diabetes is expected to rise to 643 million by 2030.
Diabetes, with the medical term diabetes mellitus, is a metabolic disease in which the blood sugar (glucose) level is higher than normal. This happens either because the pancreas does not produce enough of the hormone insulin, or because the body’s cells do not respond properly to the insulin produced. Diabetes mellitus is classified into four broad categories: Type 1, Type 2, gestational diabetes, and "other specific types". The most common type is type 2 diabetes, and more than 90 % of the adults worldwide with diabetes are dealing with this type. And indications suggest that incontinence is most prevalent in those with type 2 diabetes.
With these numbers in mind, let’s take a closer look at type 2 diabetes and its characteristics.
What characterizes type 2 diabetes:
Type 2 diabetes is the most common type of diabetes, and research shows that the likelihood of developing type 2 diabetes increases after the age of 45. It is a chronic disease, meaning that once you are diagnosed, you will live with it for life.
In type 2 diabetes, the body’s cells become less sensitive to insulin, which is necessary for the cells to absorb sugar from the blood. Although insulin is still produced by the pancreas, the cells cannot utilise it effectively - this is known as insulin resistance. As a result, the cells struggle to absorb sugar from the blood.
When type 2 diabetes is not treated, the cells do not absorb enough sugar, and the pancreas compensates by producing more insulin. At first, this helps the cells absorb the sugar they need. However, when the pancreas becomes overworked from producing excess insulin over time, it gradually becomes less efficient, leading to worsening insulin production and high blood sugar levels.
In the chart below, you see some of the symptoms and risk factors connected to Type 2 diabetes.
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Symptoms of type 2 diabetes: |
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Frequent urination incl. at night |
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Unintentional weight loss |
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Lack of energy |
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Excessive thirst and dry mouth |
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Wounds taking longer to heal |
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Blurred vision |
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Recurrent skin infections |
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Risk factors for type 2 diabetes: |
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Family history |
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Unhealthy diet |
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Increasing age |
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Physical inactivity |
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Overweight |
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High blood pressure |
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Impaired glucose tolerance (IGT) |
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History of gestational diabetes |
While some people are genetically predisposed, lifestyle plays the most significant role in the development of type 2 diabetes. In short, having a genetic risk does not mean you will develop the condition. The choices you make in diet, exercise, and daily habits can significantly affect your risk.
The other well-known type of diabetes is type 1. It is less frequent and varies slightly from Type 2 diabetes.
What characterizes type 1 diabetes:
Type 1 diabetes often develops during childhood. It is believed to result from an autoimmune reaction, where the body’s immune system attacks the beta cells in the pancreas that produce insulin. As a result, the body produces little or no insulin, causing blood sugar levels to remain high unless managed with medication.
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Symptoms of type 1 diabetes: |
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Frequent urination |
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Persistent thirst |
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Fatigue or lack of energy |
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Unintentional weight loss or, in some cases, weight gain |
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Diabetes ketoacidosis (DKA) |
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Tingling or numbness in the hands or feet |
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Blurred vision |
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Erectile dysfunction (in men) |
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Risk factors for type 1 diabetes: |
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Family history: Having a parent or sibling with type 1 diabetes slightly increases your risk. |
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Viral infections |
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Other autoimmune conditions |
Type 1 diabetes can occur at any age but is most commonly diagnosed in two age groups: children aged 4–7 years and children aged 10–14 years.
The link between diabetes and incontinence
Diabetes is associated with a risk of incontinence. Research shows that women living with diabetes may have up to a 70% higher risk of urinary incontinence than those without the condition.
By nature, diabetes causes elevated glucose levels, decreased blood flow, and nerve damage, which can affect sensory function and bladder sensation. These complications may lead to changes in bladder control, resulting in overactive bladder (OAB) or overflow incontinence. High blood sugar levels can contribute to frequent urinary tract infections (UTI), which can contribute to an overactive bladder and urinary frequency. Furthermore, too high blood sugar means that more sugar will be excreted in the urine. Since sugar binds fluid, it will cause more frequent urination, dehydration, and increased thirst.
This occurs due to diabetic neuropathy - nerve damage that interferes with communication between the bladder muscles and the brain. When these nerves are affected, the bladder may not sense fullness correctly or may fail to empty completely. This can cause leakage even when the bladder is not full or overflow when it becomes too full, similar to a cup of water running over.
High blood sugar levels can also contribute to urinary tract infections (UTIs), which can further irritate the bladder and increase urinary frequency. In addition, excess sugar in the blood is excreted in the urine, and since sugar binds fluid, it leads to more frequent urination, dehydration, and increased thirst.
The excessive thirst that often accompanies diabetes can also worsen incontinence. Drinking large amounts of fluids at once puts pressure on the bladder and can cause nocturia, the need to urinate multiple times at night, disrupting sleep and irritating the bladder.
Medication
People with type 2 diabetes are more likely to develop various medical problems such as damage to their eyes, nerves, kidneys, and blood vessels as well as heart attacks and strokes. The primary goal of diabetes medication is to help maintain stable blood sugar levels and prevent such complications.
However, it is important to be aware that some medications may cause urinary or fecal incontinence as a side effect.
Certain diabetes medications help regulate high blood sugar by forcing glucose out of the body through urine. This can irritate the bladder, leading to incontinence. If you experience these symptoms, it is important to discuss them openly with your healthcare provider - treatment and adjustments can often improve comfort and quality of life.
Many people hesitate to discuss incontinence, but managing these symptoms can greatly improve physical, psychological, and social well-being. Addressing incontinence can also help restore confidence and support a better quality of life.
Obesity and incontinence risk
Type 2 diabetes is often associated with excess body weight, and if that’s the case, it can also be a cause of incontinence. Excess body weight places additional intra-abdominal pressure on the bladder and pelvic floor muscles, leading to stress incontinence (leakage during physical exertion) and urge incontinence (a sudden, intense need to urinate).
What to be aware of:
- Increased abdominal pressure from obesity can cause stress incontinence.
- Nerve damage may reduce bladder control, leading to frequent urination (more than 8 times during the day and more than twice at night).
- A compromised immune system increases the risk for urinary tract infections (UTIs), which can cause incontinence leading to frequent urination.
- Some diabetes medication may cause diarrhea.
- Increased thirst leads to more frequent toilet visits.
- Social withdrawal.
- Noticeable odour of urine or feces.
- Rushing to the toilet in fear of bladder leakage.
Guidance tips for diabetic patients:
- Have a physical examination to determine if incontinence is related to diabetes and if it is treatable.
- Keep blood sugar levels within the target range.
- Practice proper bladder emptying, such as double or triple voiding.
- Drink approximately 1.5 litres of fluid per day to prevent UTIs and bladder irritation.
- Follow a bladder training routine - avoid going “just in case.” This helps the bladder regain normal capacity over time.
- Avoid caffeine and other bladder irritants.
- Maintain a healthy weight to reduce abdominal pressure.
- Use incontinence products that fit your body and lifestyle - as small as possible, as large as necessary.
Treatment options
Although diabetic nerve damage cannot be reversed, there are effective ways to manage symptoms and prevent further complications. The first step is to keep blood sugar consistently within a healthy range.
Possible management strategies include:
- Scheduled voiding, urinating at regular intervals to prevent accidental leakage.
- Dietary changes to avoid bladder irritants such as caffeine and alcohol.
- Medications to treat overactive bladder symptoms, if prescribed by a doctor.
- Catheterization in advanced cases to ensure full bladder emptying.
- Surgical procedures, if other treatments are ineffective.
Prevention
People with diabetes can stop the development of neurogenic bladder by controlling blood sugar levels and preventing autonomic nerve damage from happening. Get a well-regulated diabetes with insulin if type 1 where the amount of insulin is based on the weight, age, physical activity level, types of food eaten and the blood glucose level at any given time. If living with type 2 it can be regulated by regulating your lifestyle – and if necessary, diabetes type 2 medication can be provided.
Diabetes mellitus Type 2 is preventable by lifestyle interventions like exercise and diet. Some research suggests that nearly 50% of severe incontinence could be avoided by preventing type 2 diabetes.
Six tips for controlling diabetes through lifestyle changes
- Exercise regularly – Physical activity helps reduce blood sugar levels.
- Eat healthily – Focus on vegetables, fruits, whole grains, lean meats, and low-fat dairy. Limit sugar, refined carbohydrates, and high-fat foods.
- Manage stress – Stress can raise blood sugar levels.
- Stop smoking – Smoking can worsen circulation and increase health risks.
- Get regular check-ups – Visit your doctor at least twice a year and have an annual full exam to monitor diabetes and related conditions.
- Limit alcohol – Alcohol can cause both high and low blood sugar fluctuations.
How ABENA can help you
Living with diabetes and incontinence can be challenging, but the right product can make a significant difference. Wearing the appropriate continence product can improve quality of life, helping you stay active and confident.
See our range here - don’t hesitate to contact your local distributor to find the products to cover your needs.