Brown Jeanette S, Vittinghoff Eric, Lin Feng, Nyberg Leroy M, Kusek John W, Kanaya Alka M
Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF Women's Health Clinical Research Center, University of California-San Francisco, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115, USA.
Diabetes Care. 2006 Jun;29(6):1307-12. doi: 10.2337/dc05-2463.
Diabetes is associated with increased risk of urinary incontinence. It is unknown whether women with pre-diabetes, or impaired fasting glucose (IFG), have increased prevalence of incontinence. We determined the prevalence of, and risk factors for, incontinence among U.S. women with diabetes and IFG.
The 2001-2002 National Health and Nutrition Examination Survey measured fasting plasma glucose and obtained information about diabetes and urinary incontinence among 1,461 nonpregnant adult women. Self-reported weekly or more frequent incontinence, both overall and by type (urge and stress), was our outcome.
Of the 1,461 women, 17% had diabetes and 11% met criteria for IFG. Prevalence of weekly incontinence was similar among women in these two groups (35.4 and 33.4%, respectively) and significantly higher than among women with normal fasting glucose (16.8%); both urge and stress incontinence were increased. In addition to well-recognized risk factors including age, weight, and oral estrogen use, two microvascular complications caused by diabetes, specifically macroalbuminuria and peripheral neuropathic pain, were associated with incontinence.
Physicians should be alert for incontinence, an often unrecognized and therefore undertreated disorder, among women with diabetes and IFG, in particular those with microvascular complications. The additional prospect of improvements in their incontinence may help motivate some high-risk women to undertake difficult lifestyle changes to reduce their more serious risk of diabetes and its sequelae.
糖尿病与尿失禁风险增加相关。糖尿病前期或空腹血糖受损（IFG）的女性尿失禁患病率是否增加尚不清楚。我们确定了美国糖尿病和IFG女性中尿失禁的患病率及其危险因素。
2001 - 2002年国家健康与营养检查调查测量了空腹血糖，并获取了1461名非妊娠成年女性的糖尿病和尿失禁信息。我们的研究结果是自我报告的每周或更频繁的尿失禁情况，包括总体情况以及按类型（急迫性和压力性）分类的情况。
在这1461名女性中，17%患有糖尿病，11%符合IFG标准。这两组女性每周尿失禁的患病率相似（分别为35.4%和33.4%），且显著高于空腹血糖正常的女性（16.8%）；急迫性和压力性尿失禁均有所增加。除了年龄、体重和口服雌激素使用等公认的危险因素外，糖尿病引起的两种微血管并发症，即大量白蛋白尿和周围神经病理性疼痛，也与尿失禁有关。
医生应警惕糖尿病和IFG女性中的尿失禁情况，这是一种常常未被认识到因而未得到治疗的疾病，尤其是那些有微血管并发症的女性。尿失禁状况改善的额外前景可能有助于激励一些高危女性进行艰难的生活方式改变，以降低她们患更严重糖尿病及其后遗症的风险。
