Prevalence and Associated Factors of Overactive Bladder in Japanese Patients With Type 2 Diabetes

Overactive bladder (OAB) is a common lower urinary tract symptom that significantly impairs quality of life (QOL) in patients with diabetes. However, its true prevalence and its relationship with antidiabetic medications remain unclear. This study aimed to assess the prevalence of OAB and identify associated factors in Japanese patients with type 2 diabetes.

We conducted a cross-sectional study involving 289 outpatients aged ≥ 55 years with type 2 diabetes. OAB was assessed using the validated Overactive Bladder Symptom Score (OABSS). The diagnosis of OAB was defined as an urgency score (Q3) ≥ 2 and a total OABSS ≥ 3, or the current use of medications for OAB or benign prostatic hyperplasia (BPH). Logistic regression analyses were performed to identify factors independently associated with OAB.

The overall prevalence of OAB was 24%. Multiple regression analysis revealed that longer duration of diabetes (OR 1.04; 95% CI 1.00-1.08; p = 0.04), history of cerebrovascular disease (OR 2.67; 95% CI 1.05-76.77; p = 0.04), and use of sodium-glucose cotransporter 2 (SGLT2) inhibitors (OR 2.34; 95% CI 1.20-4.67; p = 0.01) were independently associated with OAB. In contrast, no significant associations were observed with HbA1c levels or peripheral neuropathy. Notably, only 32% of OAB patients were receiving relevant pharmacological treatment.

OAB is prevalent among older adults with type 2 diabetes. The use of SGLT2 inhibitors may contribute to its development. Clinicians should actively monitor urinary symptoms and consider OAB when selecting antidiabetic therapies. Early detection and appropriate treatment of OAB may help maintain QOL in this population.