Established and emerging treatments for diabetes-associated lower urinary tract dysfunction

Area of Science:

• Urology
• Endocrinology
• Pharmacology

Background:

• Diabetes mellitus is a common cause of lower urinary tract (LUT) dysfunction, affecting bladder and prostate health.
• Manifestations include overactive bladder, underactive bladder, urinary incontinence, and worsened benign prostate hyperplasia symptoms.

Purpose of the Study:

• To review the efficacy of established medications for diabetic LUT dysfunction.
• To explore the impact of antidiabetic drugs and emerging therapies on LUT function.
• To examine non-pharmacological interventions for diabetic bladder dysfunction.

Main Methods:

• Selective literature search on classic medications (e.g., receptor antagonists, agonists, PDE5 inhibitors).
• Review of studies on antidiabetic medications, particularly insulin in animal models.
• Analysis of emerging treatments and non-pharmacological approaches in preclinical studies.

Main Results:

• Classic LUT medications show comparable efficacy in diabetic and non-diabetic patients/animals.
• Insulin effectively prevents and reverses LUT alterations in type 1 diabetes animal models.
• Data on type 2 diabetes medications and emerging therapies are inconclusive but promising.

Conclusions:

• Insulin demonstrates potential for reversing diabetes-associated LUT dysfunction in preclinical type 1 diabetes models.
• Targeting diabetes itself or hyperglycemia-induced changes is crucial for treating diabetic uropathy.
• Further experimental and clinical research is essential to confirm findings and develop effective treatments.