Lifestyle Intervention Is Associated With Lower Prevalence of Urinary Incontinence
Open accessAbstract
OBJECTIVE—Diabetes is associated with increased urinary incontinence risk. Weight loss improves incontinence, but exercise may worsen this condition. We examined whether an intensive lifestyle intervention or metformin therapy among overweight pre-diabetic women was associated with a lower prevalence of incontinence. RESEARCH DESIGN AND METHODS—We analyzed data from the Diabetes Prevention Program, a randomized controlled trial in 27 U.S. centers. Of the 1,957 women included in this analysis, 660 (34%) were randomized to intensive lifestyle therapy, 636 (32%) to metformin, and 661 (34%) to placebo with standard lifestyle advice. The main outcome measure was incontinence symptoms by frequency and type by a validated questionnaire completed at the end-of-trial visit (mean 2.9 years). RESULTS—The prevalence of total (stress or urge) weekly incontinence was lower among women in the intensive lifestyle group (38.3%) than those randomized to metformin (48.1%) or placebo (45.7%). This difference was most apparent among women with stress incontinence (31.3% for intensive lifestyle group vs. 39.7% for metformin vs. 36.7% for placebo, P = 0.006). Changes in weight accounted for most of the protective effect of the intensive lifestyle intervention on stress incontinence. CONCLUSIONS—Less-frequent urinary incontinence may be a powerful motivator for women to choose lifestyle modification to prevent diabetes.
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The DPP lifestyle intervention had additional benefits that might impact older adults: reduction in urinary incontinence, improvement in several quality of life domains, and improvements in cardiovascular risk factors.
“additional benefits of the lifestyle intervention that might impact older adults: reduction in urinary incontinence20, improvement in several quality of life domains21, and improvements in cardiovascular risk factors22”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [20]
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Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873 · cited 2× · see citing works
“Recently, large randomized controlled trials have shown that diabetes can be prevented by intensive lifestyle intervention in this high-risk pre-diabetic group (3,4) Urinary incontinence, present in nearly 50% of middle-aged and older women, results in psychological stress and social isolation and has a profound effec…”
BackgroundReport of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus* (2002) · Diabetes Care · doi:10.2337/diacare.25.2007.s5 · Cited by 10,320 · see citing works
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) · Diabetes Care · doi:10.2337/diacare.20.7.1183 · Cited by 6,220 · see citing works
The Diabetes Prevention Program (DPP)
The Diabetes Prevention Program (DPP) Research Group (2002) · Diabetes Care · doi:10.2337/diacare.25.12.2165 · Cited by 1,938 · see citing works
A community-based epidemiological survey of female urinary incontinence:
Hannestad, Y. S., Rørtveit, G., Sandvik, H., & Hunskaar, S. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00232-8 · Cited by 1,325 · see citing works
A collection of Physical Activity Questionnaires for health-related research.
Pereira, M. A., FitzerGerald, S. J., Gregg, E. W., JOSWIAK, M. L., Ryan, W. J., Suminski, R. R., Utter, A. C., & Zmuda, J. M. (1997) · PubMed · Cited by 1,051 · see citing works
(1999) · Diabetes Care · doi:10.2337/diacare.22.4.623 · Cited by 725 · see citing works
Introduction to a Collection of Physical Activity Questionnaires
Kriska, A. M., & Caspersen, C. J. (1997) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199706001-00003 · Cited by 447 · see citing works
Annual Direct Cost of Urinary Incontinence
Wilson, L., Brown, J. S., Shin, G. P., et al. (2001) · Obstetrics and Gynecology · doi:10.1097/00006250-200109000-00007 · Cited by 422 · see citing works
Self-citationPrevalence of urinary incontinence and associated risk factors in postmenopausal women
Js, B. (1999) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(99)00263-x · Cited by 410 · see citing works
Postmenopausal hormones and incontinence: the heart and Estrogen/Progestin Replacement Study
Grady, D. L. (2001) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(00)01115-7 · Cited by 362 · see citing works
Obesity and lower urinary tract function in women: Effect of surgically induced weight loss
Bump, R. C., Sugerman, H. J., Fantl, J. A., & McClish, D. K. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(11)91418-5 · Cited by 322 · see citing works
WEIGHT LOSS: A NOVEL AND EFFECTIVE TREATMENT FOR URINARY INCONTINENCE
Subak, L. L., Whitcomb, E. L., Shen, H., Saxton, J., Vittinghoff, E., & Brown, J. S. (2005) · The Journal of Urology · doi:10.1097/01.ju.0000162056.30326.83 · Cited by 313 · see citing works
Self-citationAnnual direct cost of urinary incontinence
Wilson, L. (2001) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(01)01464-8 · Cited by 272 · see citing works
Sandvik, H. (1995) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)00147-i · Cited by 240 · see citing works
Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women
Sampselle, C. M. (2002) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(02)02241-x · Cited by 223 · see citing works
Urinary Incontinence in Elderly Women: Findings From the Health, Aging, and Body Composition Study
Jackson, R., Vittinghoff, E., Kanaya, A. M., Miles, T. P., Resnick, H. E., Kritchevsky, S. B., Simonsick, E. M., & Brown, J. S. (2004) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000133482.20685.d1 · Cited by 207 · see citing works
Self-citationEstimated Number of Adults With Prediabetes in the U.S. in 2000
Benjamin, S. M., Valdez, R. A., Geiss, L. S., Rolka, D. B., & Narayan, K. M. V. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.645 · Cited by 191 · see citing works
Diabetic Cystopathy: Relationship to Autonomic Neuropathy Detected by Sympathetic Skin Response
Ueda, T., Yoshimura, N., & Yoshida, O. (1997) · The Journal of Urology · doi:10.1016/s0022-5347(01)65209-1 · Cited by 181 · see citing works
Nygaard, I., DeLancey, J., Arnsdorf, L., & Murphy, E. (1990) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(90)90554-x · Cited by 176 · see citing works
Does Weight Loss Improve Incontinence in Moderately Obese Women?
Subak, L. L., Johnson, C., Johnson, C., et al. (2002) · International Urogynecology Journal · doi:10.1007/s001920200008 · Cited by 166 · see citing works
Development of Urinary Bladder Dysfunction in Diabetes Mellitus
Ellenberg, M. (1980) · Annals of Internal Medicine · doi:10.7326/0003-4819-92-2-321 · Cited by 152 · see citing works
Wetle, T. T., Scherr, P. A., Branch, L. G., et al. (1995) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1995.tb05806.x · Cited by 140 · see citing works
Too wet to exercise? Leaking urine as a barrier to physical activity in women
Brown, W. J., & Miller, Y. D. (2001) · Journal of science and medicine in sport · doi:10.1016/s1440-2440(01)80046-3 · Cited by 139 · see citing works
Brown, J. S., Nyberg, L. M., Kusek, J. W., et al. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2003.353 · Cited by 116 · see citing works
Self-citationLowering the Criterion for Impaired Fasting Glucose Will Not Provide Clinical Benefit
Davidson, M. B., Landsman, P. B., & Alexander, C. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.12.3329 · Cited by 84 · see citing works
Prevalence of Urinary Incontinence and Associated Risk Factors in Postmenopausal Women
Brown, J. S., Grady, D. G., Ouslander, J. G., Herzog, A. R., Varner, R. E., & Posner, S. F. (1999) · Obstetrics and Gynecology · doi:10.1097/00006250-199907000-00013 · Cited by 72 · see citing works
Self-citationUrinary Incontinence Predictors and Life Impact in Ethnically Diverse Perimenopausal Women
Sampselle, C. M., Harlow, S. D., Skurnick, J., et al. (2002) · Obstetrics and Gynecology · doi:10.1097/00006250-200212000-00013 · Cited by 41 · see citing works
Postmenopausal Hormones and Incontinence
Grady, D. G., Brown, J. S., Vittinghoff, E., Applegate, W. B., Varner, E. R., & Snyder, T. E. (2001) · Obstetrics and Gynecology · doi:10.1097/00006250-200101000-00023 · Cited by 37 · see citing works
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Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914 · see citing works
(2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00291-0 · Cited by 1,029 · see citing works
Diabetes in Older Adults: A Consensus Report
Sue Kirkman, M., Briscoe, V. J., Clark, N., Florez, H., Haas, L. B., Halter, J. B., Huang, E. S., Korytkowski, M. T., Munshi, M. N., Odegard, P. S., et al. (2012) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12035 · Cited by 548 · see citing works
Reach and use of diabetes prevention services in the United States, 2016-2017.
Ali, M. K., McKeever Bullard, K., Imperatore, G., Benoit, S. R., Rolka, D. B., Albright, A. L., & Gregg, E. W. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.3160 · Cited by 153 · see citing works
Phelan, S., Kanaya, A. M., Subak, L. L., Hogan, P. E., Espeland, M. A., Wing, R. R., Burgio, K. L., DiLillo, V., Gorin, A. A., West, D. S., et al. (2012) · Journal of Urology · doi:10.1016/j.juro.2011.10.139 · Cited by 107 · see citing works
Self-citationClinical guideline for female lower urinary tract symptoms
TAKAHASHI, S., TAKEI, M., NISHIZAWA, O., YAMAGUCHI, O., KATO, K., GOTOH, M., YOSHIMURA, Y., TAKEYAMA, M., OZAWA, H., SHIMADA, M., et al. (2016) · LUTS: Lower Urinary Tract Symptoms · doi:10.1111/luts.12111 · Cited by 47 · see citing works
Pelvic floor dysfunction and obesity
Chilaka, C., Toozs-Hobson, P., & Chilaka, V. (2023) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2023.102389 · Cited by 42 · see citing works
- Authors
- Brown, J. S., Wing, R., Barrett-Connor, E., Nyberg, L. M., Kusek, J. W., Orchard, T. J., Ma, Y., Vittinghoff, E., Kanaya, A. M., & for the Diabetes Prevention Program Research Group
- Affiliations
- George Washington University (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-02-01
- Volume
- 29
- Issue
- 2
- Pages
- 385-390
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2045174693
- Cited by
- 154
- References
- 30
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 8 · 2022: 2 · 2021: 12 · 2020: 5 · 2019: 9 · 2018: 8 · 2017: 9 · 2016: 8 · 2015: 10 · 2014: 9 · 2013: 5 · 2012: 12
- FWCI
- 6.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- Bristol-Myers Squibb
- Henry M. Jackson Foundation
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute on Aging
- National Institute of Diabetes and Digestive and Kidney Diseases (P50DK064538, U01DK048489)
- National Institute of Child Health and Human Development
- National Center for Research Resources
- National Institute on Minority Health and Health Disparities
- Office of Women's Health
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- urinary incontinence, stress urinary incontinence, urge urinary incontinence, intensive lifestyle intervention, metformin, prediabetes, overweight women, weight loss, diabetes prevention, Diabetes Prevention Program
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Diet, Female, Humans, Hypoglycemic Agents, Life Style, Metformin, Middle Aged, Surveys and Questionnaires, Urinary Incontinence, Weight Loss, Exercise
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