Prevalence,Influencing Factors And Impact On Quality Of Life Of Urinary Incontinence In Patients With Type 2 Diabetes Mellitus

Objectives1.To survey the prevalence of urinary incontinence in patients with type 2 diabetes mellitus(T2DM);2.To explore the influencing factors of UI in patients with T2DM,in order to provide theoretical basis for the prevention and intervention of UI;3.To analyze the impact of UI on the quality of life of patients with T2DM and provide targeted nursing measures to improve their quality of life.MethodA cross-sectional survey was conducted on 319 T2DM patients hospitalized in the Department of Endocrinology,Jiangsu Geriatric Hospital from December 2019 to December 2020.The self-made questionnaire on influencing factors of urinary incontinence was used to collect socio-demographic data(age,sex,smoking status,etc.)and clinical data(chronic history,duration of T2DM,blood glucose control level,etc.),and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UISF)was used to evaluate the type and severity of urinary incontinence.The EQ-5D-VAS was used to evaluate the quality of life of all the subjects,and the urinary incontinence quality of Life scale(I-QOL)was used to evaluate the quality of life of the patients with UI.Input the data into EpiData3.1 data,and use SPSS22.0 software package for data analysis.ResultsA total of 319 questionnaires were sent out,with a recovery rate of 100%,and a total of 273 valid questionnaires,with an effective rate of 85.58%.1.Prevalence of UI in patients with T2DM(1)The prevalence rate of UI in T2DM patients was 49.5%,and the main type was UUI(32.6%).And,the prevalence rate of UI in women(59.8%)was higher than that in men(41.7%).(2)The prevalence rates of mild,moderate and severe UI were 3.3%,36.6%and 9.5%,respectively.(3)The prevalence rate of UI increases with age and the duration of T2DM.The prevalence rate of UI in<60 years old is 28.8%and in≥ 60 years old is 58.0%.The prevalence rates of UI with the duration of T2DM<10 years,(10-20)years,(20-30)years and≥30 years were 36.3%,64.4%,64.9%and 85.7%respectively.2.Analysis of influencing factors of UI in patients with T2DM(1)In the total population,the influencing factors screened by forward stepwise logistic regression were age,HbAlc,peripheral neuropathy,stroke,retinopathy and constipation.Among them,the risk of UI increased by 5.0%with age increasing[OR=1.050,95%Cl(1.020-1.079),P=0.001];for each unit of HbAlc(%),the risk of UI increased by 61.7%[OR=1.617,95%CI(1.351-1.936),P=0.000];the risk of UI in T2DM with peripheral neuropathy was 3.703 times higher than that in T2DM without peripheral neuropathy[OR=3.703,95%CI(1.737-7.895),P=0.001];for T2DM with stroke,the risk of UI was 3.333 times higher than that without stroke[OR=3.333,95%CI(1.639-6.779),P=0.001];the risk of UI in T2DM patients with retinopathy was 3.939 times higher than that without retinopathy[OR=3.939,95%CI(1.465-10.591),P=0.007];the risk of UI in T2DM with constipation was 3.047 times higher than that without constipation[OR=3.047,95%CI(1.280-7.254),P=0.012].(2)In different types of UI,age mainly increased the risk of UUI[OR=1.044,95%CI(1.012-1.078),P=0.008],and the duration of T2DM mainly increased the risk of SUI OR=1.076,95%CI(1.004-1.154),P=0.038]。(3)In different genders,the duration of T2DM was an important influencing factor of female UI[OR=1.098,95%CI(1.043-1.156),P=0.000],while age was an important influencing factor of male UI[OR=1.084,95%CI(1.048-1.122),P=0.000].3.The impact of UI on quality of life(1)The median score of VAS in UI group was lower than that in non-UI group(P=0.000).(2)The total score of I-QOL and the scores of three dimensions of UI patients were low,the highest total score of I-QOL was 68.18,the lowest score was 13.64,and the average score was(43.68±9.43).The scores of limiting behavior,Psychosocial impacts and Social embarrassment were(37.87±9.38),(53.13 ± 10.02),and(45.38±8.03)respectively.(3)The total I-QOL scores of SUI,UUI and MUI decreased in turn,and the difference between groups was statistically significant(P=0.000).The total score of I-QOL of female UI was lower than that of male(P=0.002),and the total score of I-QOL of mild,moderate and severe UI decreased in turn,and the difference between groups was statistically significant(P=0.000).The total I-QOL score of UI patients with T2DM course<10 years,(10-20)years,(20-30)years and>30 years decreased in turn and the difference between groups was statistically significant(P=0.003).However,the difference in the total score of I-QOL of the above groups is largely due to the difference in the score of behavior restriction dimension.In addition,in the above groups,only UI with different severity had significant differences in the dimensions of Social Psychology(P=0.013)and social embarrassment(P=0.000).Conclusions1.UI is very common in patients with T2DM,especially in patients with a duration of T2DM≥10 years,and the prevalence rate of T2DM is higher than that of other microvascular complications,of which UUI is the main type.Therefore,in the education of diabetic patients to prevent complications,the relevant knowledge of UI should be added to improve diabetic patients’ understanding of UI.2.Higher age,longer duration of T2DM,higher HbAlc,constipation,stroke,diabetic peripheral neuropathy and retinopathy were risk factors for UI.3.UI seriously reduced the quality of life of patients,among them,the most prominent impact on limiting behavior,and with the aggravation of the severity of UI and the extension of the duration of T2DM,the quality of life of UI also gradually decreased.Among them,the quality of life of female patients with UI is lower than that of men,and the quality of life of MUI is the worst among different types of UI.