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J Urol. 2014 Jul;192(1):144-9. doi: 10.1016/j.juro.2014.02.036. Epub 2014 Feb 14.

Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with type 2 diabetes: results from the Look AHEAD trial.

Author information

1
Department of Urology, University of California San Francisco, San Francisco, California. Electronic address: bbreyer@urology.ucsf.edu.
2
Kinesiology Department, California Polytechnic State University, San Luis Obispo, California.
3
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
4
New England Research Institutes, Watertown, Massachusetts.
5
Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
6
Department of Psychiatry and Human Behavior, Brown Medical School and The Miriam Hospital, Providence, Rhode Island.
7
Departments of Obstetrics, Gynecology and Reproductive Sciences; Urology and Epidemiology, UCSF Women's Health Clinical Research Center, San Francisco, California.

Abstract

PURPOSE:

We determined the effect of an intensive lifestyle intervention on the prevalence, incidence and resolution of bothersome nocturia, increased daytime urinary voiding and urinary incontinence in overweight/obese men with type 2 diabetes after 1 year in the Look AHEAD trial.

MATERIALS AND METHODS:

A subset of male Look AHEAD participants was selected for this secondary data analysis. Overall 1,910 men with an average (mean ± SD) age of 59.9 ± 6.7 years and body mass index of 35.2 ± 5.5 kg/m(2) were randomized to an intensive lifestyle intervention or diabetes support and education group. All participants self-reported information regarding incontinence, nocturia and daytime urinary voiding at entry and 1 year.

RESULTS:

After 1 year the intensive lifestyle intervention group lost significantly more weight than the diabetes support and education group (9.4% ± 7.0% vs 0.7% ± 4.5%, respectively; p <0.001). The odds of prevalent urinary incontinence at 1 year were reduced by 38% in the intensive lifestyle intervention group compared to the diabetes support and education group. The prevalence of urinary incontinence decreased from 11.3% to 9.0% in the intensive lifestyle intervention group and increased from 9.7% to 11.6% in the diabetes support and education group. The intensive lifestyle intervention group also had increased odds of urinary incontinence resolving (OR 1.93, 95% CI 1.04-3.59, p = 0.04 and 56.0% vs 40.7%, p = 0.03) and trend toward reduced odds of new onset, incident urinary incontinence (OR 0.66, 95% CI 0.42-1.02, p = 0.06) compared with the diabetes support and education arm. In contrast, no differences between intensive lifestyle intervention and diabetes support and education were seen at 1 year for frequency of nocturia or frequency of daytime voiding.

CONCLUSIONS:

Intensive lifestyle intervention should be considered for the treatment of urinary incontinence in overweight/obese men with type 2 diabetes.

KEYWORDS:

diabetes mellitus; nocturia; urinary incontinence; weight loss

PMID:
24533998
PMCID:
PMC4133305
DOI:
10.1016/j.juro.2014.02.036
[Indexed for MEDLINE]
Free PMC Article

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