The prevalence and risk factors of urinary incontinence amongst Palestinian women with type 2 diabetes mellitus: A cross-sectional study

ABSTRACT

Objective: To determine the prevalence of urinary incontinence (UI) in women with type 2 diabetes mellitus (T2DM) in the North West Bank, Palestine, and to assess the role of potential risk factors including age and DM control.

Patients and methods: Adult women with DM attending governmental primary healthcare centres in the North West Bank were interviewed using the Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES) standardised UI questionnaire. The prevalence of UI was estimated and differences between groups were evaluated using the chi-square test. A multivariate logistic model was used to estimate the adjusted relationships and to control for confounders. The statistical significance level was set at P < 0.05. The study was approved by the Institutional Review Board at An-Najah National University.

Results: The study included 381 women with T2DM, aged 30–83 years, of whom 43.2% (95% confidence interval [CI] = 37.9–47.8%) reported UI regardless of the type. About 40% reported that they were extremely bothered by the condition and 35.2% stated that their daily routine life was greatly affected. Amongst the women with UI, 133 (80.6%) and 128 (77.6%) were found to have urge and stress UI, respectively. UI was found to be significantly associated with a history of recurrent urinary tract infection (adjusted odds ratio [OR] 3.0, 95% CI 1.9–4.9; P < 0.001) and parity (adjusted OR 1.7, 95% CI 1.1–2.7; P = 0.04)

Conclusions: The prevalence of UI amongst Palestinian women with T2DM regardless of the type is high. The findings highlight the importance of educating women with T2DM about UI. The medical team should focus on this problem as it is often neglected; physicians should be alert for UI as it is often underreported and therefore undertreated.

Abbreviations: BMI: body mass index; (T2)DM: (type 2) diabetes mellitus; HbA_1c: haemoglobin A_1c; MoH: Ministry of Health; NHANES: National Health and Nutrition Examination Survey; OR: odds ratio; QoL: quality of life; (S)(U)UI: (stress) (urge) urinary incontinence.

KEYWORDS:

• Urinary incontinence
• prevalence
• female
• type 2 diabetes mellitus
• Palestine

Acknowledgments

Researchers are grateful to MoH and An–Najah National University for facilitating our access to Primary Health Centres. We are thankful to NHANES, which provided us with the standardised survey instrument and Wegdan Bani-Issa who allowed us to use the Arabic version of the questionnaire. We also thank the research participants.

Disclosure statement

We declare that we have no conflicts of interest.