Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with Type 2 diabetes: Results from the look AHEAD trial

Authors: Raatz, Susan

Submitted to: Journal of Urology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/11/2014
Publication Date: 7/1/2014
Citation: Raatz, S.K. 2014. Intensive lifestyle intervention reduces urinary incontinence in overweight/obese men with Type 2 diabetes: Results from the look AHEAD trial. Journal of Urology. 192:144-149.

Interpretive Summary: 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. 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/m2 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. 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 in the intensive lifestyle intervention group and increased in the diabetes support and education group. The intensive lifestyle intervention group also had increased odds of urinary incontinence resolving and trend toward reduced odds of new onset, incident urinary incontinence 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. Intensive lifestyle intervention should be considered for the treatment of urinary incontinence in overweight/obese men with type 2 diabetes.

Technical 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/m2 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 1.04e3.59, p ¼ 0.04 and 56.0% vs 40.7%, p ¼ 0.03) and trend toward reduced odds of new onset, incident urinary incontinence (OR 0.66, 95% CI 0.42e1.02, p ¼ 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.