Prevalence and Risk Factors for Urinary Incontinence in Women With Type 2 Diabetes and Impaired Fasting Glucose

Findings from the National Health and Nutrition Examination Survey (NHANES) 2001–2002

  1. Jeanette S. Brown, MD1,
  2. Eric Vittinghoff, PHD1,
  3. Feng Lin, MS1,
  4. Leroy M. Nyberg, MD, PHD2,
  5. John W. Kusek, PHD2 and
  6. Alka M. Kanaya, MD1
  1. 1UCSF Women’s Health Clinical Research Center, University of California, San Francisco, California
  2. 2National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
  1. Address correspondence and reprint requests to Jeanette S. Brown, MD, Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF Women’s Health Clinical Research Center, 1635 Divisadero St., Suite 600, San Francisco, CA 94115. E-mail: brownj{at}


OBJECTIVE—Diabetes is associated with increased risk of urinary incontinence. It is unknown whether women with pre-diabetes, or impaired fasting glucose (IFG), have increased prevalence of incontinence. We determined the prevalence of, and risk factors for, incontinence among U.S. women with diabetes and IFG.

RESEARCH DESIGN AND METHODS—The 2001–2002 National Health and Nutrition Examination Survey measured fasting plasma glucose and obtained information about diabetes and urinary incontinence among 1,461 nonpregnant adult women. Self-reported weekly or more frequent incontinence, both overall and by type (urge and stress), was our outcome.

RESULTS—Of the 1,461 women, 17% had diabetes and 11% met criteria for IFG. Prevalence of weekly incontinence was similar among women in these two groups (35.4 and 33.4%, respectively) and significantly higher than among women with normal fasting glucose (16.8%); both urge and stress incontinence were increased. In addition to well-recognized risk factors including age, weight, and oral estrogen use, two microvascular complications caused by diabetes, specifically macroalbuminuria and peripheral neuropathic pain, were associated with incontinence.

CONCLUSIONS—Physicians should be alert for incontinence, an often unrecognized and therefore undertreated disorder, among women with diabetes and IFG, in particular those with microvascular complications. The additional prospect of improvements in their incontinence may help motivate some high-risk women to undertake difficult lifestyle changes to reduce their more serious risk of diabetes and its sequelae.


  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted March 10, 2006.
    • Received December 14, 2005.
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