Thursday 14th November is World Diabetes Day. As urology specialists, we felt this would be a great opportunity to do a special focus on diabetes and the impact this can have on bladder health. But first things first...
What is diabetes?
Diabetes is a serious condition which develops when your blood glucose levels are too high. Glucose is a sugar and this gets into our bloodstream from our food and drink. Glucose needs to get into the cells of our body where it can be used as energy. This is where insulin comes in!
What is insulin?
Insulin is a hormone created by the pancreas and it acts as a ‘key’, allowing the glucose into the cells of the body so it can be used for energy. When someone has diabetes, their pancreas either doesn’t make insulin (this is type 1 diabetes), or they can’t produce enough insulin or good-enough quality insulin (this is type 2 diabetes). When glucose is unable to get into the cells because it doesn’t have the insulin ‘key’, it builds up in the bloodstream and this can lead to various problems throughout the body.
Symptoms of diabetes
- Frequent urination – as the kidneys go into overdrive to get rid of extra glucose which has accumulated in the body
- Excessive thirst – to compensate for fluids lost when passing extra urine to get rid of glucose
- Fatigue – due to lack of energy from not correctly absorbing energy from food and drink
- Genital itching or thrush – increased glucose in the urine creates a sugary environment in which thrush can thrive
- Unintentional weight loss - when the body can't burn energy from food and drink, it starts burning fat and muscle instead
- Cuts and wounds taking longer to heal – increased blood sugar levels cause damage to the peripheral blood supply and smaller blood vessels, reducing the supply of oxygenated blood which is needed to heal wounds.
- Blurred vision – increased blood sugar levels can damage the small blood vessels in your eyes
The treatment for diabetes will vary depending on whether you’re type 1 or type 2.
Because people with type 1 diabetes are unable to produce any insulin themselves, they need to inject it daily. This is injected into the fat layer under the skin. It’s a much smaller needle than what you might see if you have a flu vaccine, for example, where the injection goes into the muscle.
It's important that people with diabetes keep a close eye on their blood sugar levels. This can help them to ensure they're staying within a safe range. This is commonly done using a finger prick blood test. A lancet is used to prick the finger, which can then be squeezed if necessary until a small amount of blood appears. A testing strip inserted into a blood glucose monitor can then be dipped into the blood. It then takes seconds for a blood sugar measurement to appear on the screen.
Many people with type 2 diabetes take oral medication in the form of tablets to control their diabetes. Lifestyle factors should also be taken into account, such as eating a healthy diet and getting plenty of exercise.
What effect does diabetes have on the bladder?
A complication of diabetes can be neuropathy. Diabetic neuropathy occurs when high blood glucose levels cause damage to the small blood vessels which supply the nerves. This can then cause the nerves to not work properly. With regards to the bladder, the following issues might occur...
- Reduced bladder sensitivity. When the bladder becomes less sensitive, the nerves in the bladder stop sending such frequent messages to the brain to communicate that it's time to go to the toilet. As a result of this, the bladder can overfill and become stretched.
- Damage to the nerves can make it difficult to empty the bladder when visiting the bathroom. Some urine may even stay in the bladder after you've been for a wee (this is called urinary retention). This can also lead to an increased risk of urinary tract infections, and even problems with your kidneys.
If you have diabetes and you're concerned about the effect this might have on your bladder (or any other organs, for that matter), please don't hesitate to talk it through with your GP. A good source of useful advice is Diabetes UK - the UK's leading diabetes charity.