Associations between lower urinary tract dysfunction and glycemic control in women with type 2 diabetes: A cross-sectional study

Abstract Aims Patients with diabetes are predisposed to develop a variety of complications, including lower urinary tract (LUT) dysfunction. We aimed to examine the associations between glycemic control and LUT dysfunction in women with type 2 diabetes (T2D). Methods We included 400 women with T2D (age range, 48–75 years) in this cross-sectional analysis. The participants were divided into tertiles according to glycosylated hemoglobin (Hb A1c ) measurements. The mean Hb A1c levels for tertiles 1, 2, and 3 were 6.2% (N=132), 7.1% (N=132), and 8.4% (N=136), respectively. We evaluated LUT dysfunction with the American Urological Association Symptom Index (AUA-SI) questionnaire, uroflowmetry (UFM), and post-void residual (PVR). Results No significant differences were found among Hb A1c tertiles regarding storage, voiding and total AUA-SI scores, and prevalence of LUT symptoms. However, women in tertile 3 had higher prevalences of severe LUT symptoms (AUA-SI≥20) and clinically significant PVR (≥100mL) compared to women in the other tertiles. Multivariate analysis revealed that diabetic neuropathy, but not Hb A1c , significantly predicted LUT symptoms in women with T2D after adjustment for age, body mass index (BMI) and hypertension. However, Hb A1c was associated with an increased risk of developing clinically significant PVR. Conclusions Our findings do not support significant associations between glycemic control and LUT symptoms in women with T2D. However, women with poor glycemic control are more likely to develop urinary retention than women with proper glycemic control. Clinicians should, therefore, be aware of and educate patients about the association between urinary retention and glycemic control.