Diabetes can cause certain urologic problems involving the bladder and urinary tract infections. There are four main ways that diabetes may cause problems controlling your bladder: obesity, nerve damage, having a weak immune system, and taking certain diabetes medications.
Obesity may affect bladder control because the excess weight can weaken the pelvic floor muscles. Nerve damage can result from poorly controlled long-term diabetes. This can cause an overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing the muscles to contract without warning. The symptoms of an overactive bladder include urinary frequency (urination eight or more times a day or two or more times a night), urinary urgency (sudden urge to urinate immediately), and urge incontinence (leakage of urine that follows a sudden, strong urge to urinate). Nerve damage can also cause poor control of sphincter muscles. The sphincter muscles may become loose and allow leakage or stay tight when a person is trying to release urine. Nerve damage may also lead to urinary retention. Nerve damage keeps the bladder muscle from getting the message that it’s time to urinate or makes the muscles too weak to completely empty. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. If urine remains in the body for too long, kidney or bladder infection can develop
Having a weak immune system as a result of diabetes can increase your risk for developing a urinary tract infection. The symptoms of a urinary tract infection include frequent urge to urinate (which may be a sign of high blood glucose), pain or burning in the bladder or urethra during urination, cloudy or reddish urine, women have pressure above pubic bone, and men may experience a feeling of fullness in rectum. This may eventually cause a bladder or kidney infection.
Certain diabetes medications may cause bladder or bowel control problems. The combination of weak pelvic floor muscles and medications may cause bowel incontinence. For example, type 2 diabetes medications may cause diarrhea. These medications include Metformin, Acarbose and Gliclazide.
Fortunately, there are treatment options available for bladder problems as a result of nerve damage. The type of treatment varies depending on the type of bladder problem. For urinary retention, options include medication to promote better bladder emptying, timed voiding-urinating on a schedule to promote more efficient urination, periodical self-catheterization, and learning how to tell when the bladder is full and how to massage the lower abdomen to fully empty the bladder. For urinary leakage, options include medication, kegel exercises, or surgery. For urinary urgency and frequency from overactive bladder, options include medications, timed voiding, kegel exercises, or surgery.