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Pelvic Floor Disorders, Diabetes Mellitus, and Obesity in Women: Findings from the KP CARES Study

¹= Research & Evaluation, Kaiser Permanente Southern California, Pasadena CA
²=Women's Pelvic Medicine Center, University of California San Diego, San Diego CA
³=Department of Female Pelvic Medicine, Kaiser Permanente San Diego Medical Center, San Diego CA

jean.m.lawrence{at}kp.org

ABSTRACT

Objective:We examined associations between obesity, diabetes mellitus, and female pelvic floor disorders (PFD); stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI); in community dwelling women

Research Design & Methods:Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases while other risk factors for PFD were obtained through self-report. Women were categorized hierarchically as non-obese/non-diabetic (reference); non-obese/diabetic; obese/non-diabetic; and obese/diabetic.

Results:Of 3,962 women, 393 (10%) had diabetes. In unadjusted analyses, women with diabetes and women who were obese had greater odds of having each PFD. Among women with diabetes, being obese was associated with SUI and OAB. After adjusting for confounders, we found that obese/diabetic women were at the highest likelihood of having SUI (odds ratio [OR] 95% confidence interval (CI) 3.67; 2.48-5.43) and AI (OR 2.09; 1.48, 2.97). The odds of having OAB among obese women was the same for obese/diabetic women (OR 2.97; 2.08, 4.36) and obese/non-diabetic women (OR 2.93; 2.33, 3.68). Non-obese/diabetic women had higher odds of SUI (OR 1.90, 1.15, 3.11) but did not differ significantly in their OAB (OR 1.45; 0.88, 2.38) and AI (OR 1.33; 0.89, 2.00) prevalence from non-obese/non-diabetic women.

Conclusions:Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFD.

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