There are four main ways that diabetes may cause problems with bladder and bowel control:

Obesity

The pelvic floor muscles support most of your body weight.  Any excess weight further strains these muscles, weakening them.  Weak pelvic floor muscles do not support the bladder and bowel as it should. 

Nerve damage

Poorly controlled or long-term diabetes may cause nerve damage (neuropathy). Nerve damage to the bladder and bowel causes loss of sensation so there may be little warning of needing to go to the toilet or lack of awareness of the bladder filling.  The bladder and bowel may not empty well, increasing the risk of developing urinary tract infections, kidney damage or constipation

Reduced immunity

Diabetes interferes with the immune system increasing the risk of infections.  A common infection experienced by people with diabetes is urinary tract infection (UTI). 

Medication

The medications used to control Type 2 diabetes may cause loose bowel motions (diarrhoea). 

This can be caused by a neurogenic bladder, which is caused by nerve damage (neuropathy) that can happen if blood sugar levels are not bought under control.

Symptoms of neurogenic bladder include:

  • Frequency
  • Urine retention (inability to fully empty the bladder)
  • Overactive Bladder (OAB)
  • Urgency
  • Overflow incontinence
  • UTI’s

People may also experience nocturia, the need to urinate more than once during the night which can be a sign of uncontrolled blood sugar levels or a urinary tract infection. Constipation and diarrhoea can also occur and can be caused by certain medications used to control it.

Prevention includes:

  • Eating well. Including a variety of fresh whole foods. 
  • Drink well. Aim for around 1.5 - 2 Litres of fluid a day.  
  • Exercise regularly. Individuals should aim for a minimum of 30 minutes of physical activity every day. 
  • Practice good toilet habits. 

diabetes and incontinence