Gestational and Type 2 Diabetes in Relation to Urinary Incontinence in Black Women in the U.S

Urinary incontinence (UI) is a common condition in women of all ages. Type 2 diabetes (T2D) has been associated with UI, but gestational diabetes (GD), glucose intolerance first recognized during pregnancy, has received relatively little attention as an independent risk factor for UI. We explored the roles of GD and T2D, independently and in combination, on the risk of UI in a Black Women's Health Study (BWHS), a follow-up of Black women in the U.S. aged 21-69 at enrolment in 1995.

We analyzed the 28,978 parous women who had information on GD, T2D, and UI in 2011. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) using logistic regression with adjustment for several important variables, including age, parity, body mass index, and diuretic use. We also stratified analyses according to T2D status (T2D, no T2D).

The multivariable-adjusted ORs for women with a history of GD, compared to those without, was 1.18 (95% CI: 1.02, 1.37), for UI frequency of ≥1/week; the estimate among women with a history of T2D, compared to those without, was 1.16 (1.06, 1.27) for the same frequency. In stratified analyses, GD was associated with a 23% increased risk of weekly UI among women without a history of T2D, while there was no association observed among those with a history of T2D.

In the BWHS, GD was positively associated with urinary incontinence, independent of T2D status. Our results suggest that women who experience GD-even without subsequent development of T2D-might be at increased risk of UI and may benefit from early intervention.