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Long‐term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study
Author(s) -
Phelan Suzanne,
Kanaya Alka M,
Ma Yong,
Vittinghoff Eric,
BarrettConnor Elizabeth,
Wing Rena,
Kusek John W,
Orchard Trevor J,
Crandall Jill P,
Montez Maria G,
Brown Jeanette S
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12654
Subject(s) - medicine , urinary incontinence , odds ratio , diabetes mellitus , overweight , body mass index , confidence interval , randomized controlled trial , physical therapy , surgery , endocrinology
Objectives To examine the long‐term prevalence and predictors of weekly urinary incontinence in the Diabetes Prevention Program Outcomes Study, a follow‐up study of the Diabetes Prevention Program randomized clinical trial of overweight adults with impaired glucose tolerance. Methods This analysis included 1778 female participants of the Diabetes Prevention Program Outcomes Study who had been randomly assigned during the Diabetes Prevention Program to intensive lifestyle intervention ( n = 582), metformin ( n = 589) or placebo ( n = 607). The study participants completed semi‐annual assessments after the final Diabetes Prevention Program visit and for 6 years until O ctober 2008. Results At the study entry, the prevalence of weekly urinary incontinence was lower in the intensive lifestyle intervention group compared with the metformin and placebo groups (44.2% vs 51.8%, 48.0% urinary incontinence/week, P = 0.04); during the 6‐year follow‐up period, these lower rates in intensive lifestyle intervention were maintained (46.7%, 53.1%, 49.9% urinary incontinence/week; P = 0.03). Statistically adjusting for urinary incontinence prevalence at the end of the Diabetes Prevention Program, the treatment arm no longer had a significant impact on urinary incontinence during the Diabetes Prevention Program Outcomes Study. Independent predictors of lower urinary incontinence during the Diabetes Prevention Program Outcomes Study included lower body mass index (odds ratio 0.988, 95% confidence interval 0.982–0.994) and greater physical activity (odds ratio 0.999, 95% confidence interval 0.998–1.000) at the Diabetes Prevention Program Outcomes Study entry, and greater reductions in body mass index (odds ratio 0.75, 95% confidence interval 0.60–0.94) and waist circumference (odds ratio 0.998, 95% confidence interval 0.996–1.0) during the Diabetes Prevention Program Outcomes Study. Diabetes was not significantly related to urinary incontinence. Conclusions Intensive lifestyle intervention has a modest positive and enduring impact on urinary incontinence, and should be considered for the long‐term prevention and treatment of urinary incontinence in overweight/obese women with glucose intolerance.