Voiding dysfunction among female patients with diabetes mellitus

Abstract

Background: Disordered bladder dysfunction is one of the complications of diabetes mellitus that occurs in the middle aged and elderly diabetic patients. Poor glycemic control leads to production of glycated end products that cause axonal degeneration and impairment of nerve conduction. This affects autonomic innervations to the bladder muscles and leads to disordered bladder function.Objectives: To highlight voiding dysfunction among female diabetic patients attending the diabetic clinic at MTRH.Design: This was a hospital based cross sectional study .Setting: Diabetic clinic at the Moi Teaching and Referral Hospital, Eldoret ,Kenya .Subjects /Participants: Involved 255 female patients . Results: Two hundred and fifty five female diabetic patients were interviewed with a mean age of 69±16.1 years. About 72(28.2%) had voiding dysfunction while 183(71.8%) had a normal bladder function.The mean age for patients with voiding dysfunction was 59.9 years compared with 49.3 years for those normal bladder function.About 73.9% (187) out of 253 patients with recorded results had abnormal FBS of >5.6mmol/L), while 98% (197) out of 201 who had results had abnormal HB1C of >7mg/.The association between age of the patients and voiding dysfunction was statistically significant, (Pearson Chi square (2)=17.267 Pr=0.001),and also between the duration a patient has suffered from DM and presence of Voiding dysfunction P=0.001.There was no significant association between FSB (p=0.603) and HB1C(p=0.115) and voiding dysfunction.Patients with abnormal creatinine levels have odds of 1.2 of having voiding dysfunction compared to patients with normal creatinine (95.0% C.I 0.586 to 2.410). Similarly , patients with abnormal urea had 1.8 times odds higher of having voiding dysfunction (95.0% C.I 0.586 to 2.410) compared to those with normal urea levels.Conclusion: Diabetic bladder dysfunction occurs among female DM patients and age of the patient and duration the patient has lived with the disease are important risk factors.