Updated 14 November 2017

Type 2 diabetes and incontinence

Sponsored: 14 December is World Diabetes Day – find out more about diabetes and incontinence.


Type 2 diabetes is on the rise and it has been estimated by the Centre for Diabetes and Endocrinology in Johannesburg, that 3.5 million South Africans suffer from diabetes, while another five million have pre-diabetes, a condition where insulin resistance causes blood glucose levels to be higher than normal, but not high enough yet to be type 2 diabetes. It is further estimated by the International Diabetes Federation (IDF) that the prevalence of diabetes in Africa is set to double by 2030. 

What is it and what causes it? 

Type 2 diabetes results when your body resists the effects of (or does not produce enough) insulin to maintain a normal glucose (sugar) level in your body. Insulin helps regulate the levels of glucose in the body; too much glucose can damage your body over time. 

Type 2 diabetes used to largely affect adults, but worryingly, where it was rarely seen before the 1990’s, children are now being diagnosed with it. The main cause is simple; we are eating too much of the wrong types of foods and not exercising enough. Some sources say that obesity has doubled in children and tripled in adolescents over the last 30 years creating health and well-being problems.

Classic symptoms of diabetes are excessive thirst and passing more urine than usual.  This is because glucose builds up in the blood and your kidneys are forced to work overtime to filter it.  As the excess glucose is excreted into the urine, it triggers more frequent urination, which may leave you dehydrated. As you drink more fluids to quench your thirst, you'll urinate even more!

Most diabetics won’t have incontinence in the early stages. However, because high blood glucose levels cause an increase in the amount of urine produced, this may result in an overactive bladder.  This gives rise to the sensation of urgency and the need to pass urine frequently which might result in urge urinary incontinence. Urge incontinence or overactive bladder syndrome (OAB) occurs when one gets the sudden and uncontrollable urge to urinate and your bladder may leak before you can get to a toilet.

A common complication associated with diabetes is nerve damage.  Damage to the nerves of the bladder may cause incontinence due to reduced bladder sensation and chronic diabetics could have bladder muscle weakness which can affect how well they empty their bladder. This may lead to some urine being leftover in the bladder causing a urinary tract infection (UTI) making the urgency and frequency symptoms even worse.  High glucose levels also make you more prone to developing urinary infections.

Another thing to consider is how well and how regularly the bowels are moved.  Constipation affects nearly 60% of people with diabetes and can make it difficult to empty the bladder.

There is evidence now that losing weight, eating a healthy diet that reduces blood glucose and exercising regularly can help to prevent Type 2 diabetes worsening or indeed even reverse it.

The best way to prevent incontinence associated with diabetes is to:

Work closely with your healthcare professional to control blood sugar and treat any associated high blood pressure/cholesterol and obesity

Avoid alcohol and smoking

Drink plenty of water each day

Practice good perineal hygiene to help prevent infection

If you develop urinary incontinence, TENA has a range of products to help with the different situations that people may face every day, from the light leaks to the heavier incontinence problems.

The TENA Lady and Men’s ranges include pads that you can use with your own snug fitting underwear. Also available are “pull up” pants that feel like you are wearing your own underwear – to help you retain a sense of normality. 

For those with heavier incontinence and/or are bedridden we have TENA Flex which is a fully breathable belted product that allows for more ergonomic changing regardless of the individual’s position, providing a comfortable and discreet fit. TENA Flex minimises the need for moving and lifting, making pad changing less intrusive for the wearer, and has been proven to reduce the risk of back strain on carers.

For advice on bladder weakness products, please call us on 087 359 1079. Visit TENA for more information on our product range. You can also buy TENA products online at TENA Shop.

Read more:
6 steps to help reduce falls in the elderly
Compassion fatigue and what to do about it


Ask the Expert

Incontinence Expert

Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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