PURPOSE: We determined the effect of an intensive lifestyle intervention on the prevalence, incidence and resolution of bothersome nocturia, increased daytime urinary voiding, and urinary incontinence (UI) in overweight/obese men with type 2 diabetes after 1 year in the Look AHEAD (Action for Health in Diabetes) trial.
MATERIALS AND METHODS: A subset of male Look AHEAD participants were selected for this secondary data analysis. 1910 men with an average (mean +/-SD) age of 59.9 +/- 6.7 years and BMI of 35.2 +/- 5.5 kg/m2 were randomized to an intensive lifestyle intervention (ILI) or diabetes support and education (DSE) group. All participants self-reported information regarding incontinence, nocturia, and daytime urinary voiding at entry and 1 year.
RESULTS: After one year, the ILI group lost significantly more weight than the DSE group (9.4%+/-7.0% vs. 0.7%+/-4.5%, respectively; p < 0.001). The odds of prevalent UI at one year was reduced by 38% in ILI relative to DSE; the prevalence of UI decreased from 11.3% to 9.0% in ILI and increased from 9.7% to 11.6% in DSE. The ILI group also had increased odds of UI resolving (OR 1.93, 95% CI 1.04-3.59, p= 0.04) (56.0% vs 40.7%, p=0.03) and trend toward reduced odds of new-onset, incident UI (OR 0.66 (95%CI 0.42-1.02), p=0.06) compared with the DSE arm. In contrast, no differences between ILI and DSE were seen at 1 year for nocturia frequency or frequency of daytime voiding.
CONCLUSIONS: ILI should be considered for the treatment of UI in overweight/obese men with type 2 diabetes.
Written by:
Breyer BN, Phelan S, Hogan PE, Rosen RC, Kitabchi AE, Wing RR, Brown JS. Are you the author?
Department of Urology, University of California San Francisco, San Francisco, California; Kinesiology Department, California Polytechnic State University, San Luis Obispo, California; Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina; New England Research Institutes, Watertown, Massachusetts; Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Psychiatry and Human Behavior, Brown Medical School and The Miriam Hospital, Providence, Rhode Island; Departments of Obstetrics, Gynecology and Reproductive Sciences, Urology and Epidemiology, UCSF Women's Health Clinical Research Center, San Francisco, California.
Reference: J Urol. 2014 Feb 14. pii: S0022-5347(14)00288-2.
doi: 10.1016/j.juro.2014.02.036
PubMed Abstract
PMID: 24533998
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