Urinary incontinence in US adults aged ≥55 years with type 2 diabetes and indications for SGLT2is: NHANES 2013-2020.

IF 4.1 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2025-07-31 DOI:10.1136/bmjdrc-2025-004929

Alexandra K Lee, Kasia J Lipska, Kathryn E Callahan, Eva Raphael, Sei J Lee

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Abstract

Objective: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are recommended as first-line cardiorenal protective therapy in type 2 diabetes. Because SGLT2is cause glycosuria and increase urine volume, they may exacerbate incontinence symptoms among patients with pre-existing urinary incontinence. Our objective was to determine how many adults meeting guideline indications for SGLT2i have frequent urinary incontinence.

Research design and methods: We conducted a cross-sectional analysis of National Health And Nutrition Examination Survey (NHANES) participants aged ≥55 with type 2 diabetes in 2013-2020. We determined whether participants met American Diabetes Association guideline indications for an SGLT2i due to heart failure or chronic kidney disease, or due to atherosclerotic cardiovascular disease or high cardiovascular risk (for the latter two cardiovascular indications, GLP-1RAs are guideline-recommended alternative medications). Frequent urinary incontinence was defined by self-report of leaking urine daily/nightly or a few times per week.

Results: There were 1726 NHANES participants aged ≥55 with type 2 diabetes, representing 16.0 million US adults; 19.6% (95% CI 17.3% to 22.2%) (3.1 million) met indications for an SGLT2i specifically and 50.9% (95% CI 47.2% to 54.7%) (8.2 million) met indications for either an SGLT2i or a GLP-1RA. Among those with indications for an SGLT2i specifically, 32.4% (95% CI 25.9% to 39.8%) had frequent urinary incontinence, representing 333 000 men and 685 000 women. Among those with indications for either an SGLT2i or GLP-1RA, 25.5% (95% CI 20.8% to 30.8%) had frequent urinary incontinence, representing 630 000 men and 1413 000 women.

Conclusions: Frequent urinary incontinence affects >15% of men and >40% of women aged ≥55 years with guideline indications for SGLT2i. Studies are needed to determine if incontinence increases risk of genital infections when initiating SGLT2is.

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美国年龄≥55岁2型糖尿病患者尿失禁及SGLT2is适应症：NHANES 2013-2020

目的：钠-葡萄糖共转运蛋白-2抑制剂（SGLT2is）被推荐作为2型糖尿病的一线心肾保护治疗。由于SGLT2is导致糖尿和尿量增加，它们可能会加重已有尿失禁患者的尿失禁症状。我们的目的是确定有多少符合SGLT2i指南适应症的成年人经常尿失禁。研究设计和方法：我们对2013-2020年国家健康与营养调查（NHANES）中年龄≥55岁的2型糖尿病患者进行了横断面分析。我们确定参与者是否符合美国糖尿病协会指南中由于心力衰竭或慢性肾脏疾病，或由于动脉粥样硬化性心血管疾病或高危心血管疾病的SGLT2i适应症（对于后两种心血管适应症，GLP-1RAs是指南推荐的替代药物）。频繁尿失禁的定义是自我报告每天/每晚或每周几次尿漏。结果：1726名年龄≥55岁的2型糖尿病NHANES参与者，代表1600万美国成年人；19.6% (95% CI 17.3% ~ 22.2%)（310万）患者符合SGLT2i的适应症，50.9% (95% CI 47.2% ~ 54.7%)（820万）患者符合SGLT2i或GLP-1RA的适应症。在有sgltti特异性适应症的患者中，32.4% （95% CI 25.9%至39.8%）有频繁尿失禁，分别为33万3千名男性和68万5千名女性。在有SGLT2i或GLP-1RA适应症的患者中，25.5% （95% CI 20.8%至30.8%）有频繁尿失禁，分别为63万名男性和141.3万名女性。结论：伴有SGLT2i指南适应症的年龄≥55岁的患者中，频繁尿失禁影响>5 %的男性和>0 %的女性。需要进行研究以确定在启动SGLT2is时尿失禁是否会增加生殖器感染的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.