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Effect of Intensive Glycemic Control and Diabetes Complications on Lower Urinary Tract Symptoms in Men With Type 1 Diabetes

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study

  1. Stephen K. Van Den Eeden, PHD1,
  2. Aruna V. Sarma, PHD2,
  3. Brandy N. Rutledge, PHD3,
  4. Patricia A. Cleary, MS3,
  5. John W. Kusek, PHD4,
  6. Leroy M. Nyberg, MD4,
  7. Kevin T. McVary, MD5,
  8. Hunter Wessells, MD6 and
  9. for the DCCT/EDIC Research Group*
  1. 1Division of Research, Kaiser Permanente, Northern California Region, Oakland, California;
  2. 2Departments of Epidemiology and Urology, University of Michigan, Ann Arbor, Michigan;
  3. 3The Biostatistics Center, The George Washington University, Rockville, Maryland;
  4. 4National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland;
  5. 5Department of Urology, Northwestern University, Chicago, Illinois;
  6. 6Department of Urology, University of Washington School of Medicine and Harborview Medical Center, Seattle, Washington.
  1. Corresponding author: Stephen K. Van Den Eeden, stephen.vandeneeden{at}kp.org.

Abstract

OBJECTIVE Although diabetes is known to result in lower urinary tract symptoms (LUTS) in men, it remains unclear if glycemic control can mitigate urinary symptoms. We studied how diabetic characteristics are related to LUTS in the men who completed the urological assessment component (UroEDIC) of the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study of the Diabetes Control and Complications Trial (DCCT) participants.

RESEARCH DESIGN AND METHODS Study participants were men who completed the UroEDIC questionnaire at the year 10 DCCT/EDIC follow-up examination, which included data on genitourinary tract function and the American Urological Association Symptom Index (AUASI). Analyses were conducted to assess how treatment arm and diabetes characteristics were associated with LUTS using logistic regression.

RESULTS Of the 591 men who completed the AUASI questions, nearly 20% (n = 115) had AUASI scores in the moderate to severe category for LUTS (AUASI score ≥8). No associations were observed between LUTS and treatment arm, or A1C levels at the DCCT baseline or end-of-study or at the year 10 EDIC (UroEDIC) examination. Of the diabetes complications studied, only erectile dysfunction at the UroEDIC examination was associated with LUTS.

CONCLUSIONS These data from the UroEDIC cohort do not support the assumption that intensive glycemic control results in decreased lower urinary tract symptom severity in men with type 1 diabetes. This result may be due to a true lack of effect, or it may be due to other factors, for example, the relatively young age of the cohort.

Footnotes

  • *A complete list of investigators and members of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study group appears in the New England Journal of Medicine 2005;353:2643–2653.

  • 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.

    • Received December 14, 2007.
    • Accepted January 13, 2009.
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This Article

  1. Diabetes Care April 2009 vol. 32 no. 4 664-670
  1. All Versions of this Article:
    1. dc07-2375v1
    2. 32/4/664 most recent
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