Endocrine Abstracts

Objective: To determine the influence of metabolic disturbances associated with diabetes mellitus (DM) on the clinical manifestations of the diabetic neurogenic bladder (DNB).

Patients and Methods: Analytical cross-sectional study comparing two groups of patients suffering from DM: G1 (n=159) with manifestations of DNB versus G2 (n=41) without signs of DNB.

Results: G2 patients were younger than G1 patients (58±12 years vs 59.7±10.3; P=0.36) with a female predominance (63.4% vs 52%; P=0.16). The duration of diabetes was significantly longer in G1 (11.9 vs 7.7 years; P=0.03). A glycemic imbalance was statistically more pronounced in G1 (88% vs 61%; P=0.000). Patients in G1 were more likely to have high blood pressure (53.8% vs 30%) and dyslipidemia (59.7% vs 47.5%) without statistical significance. The mean BMI was significantly higher in G1 (29.2±5.5 vs 26.4±4.2 kg/m^²; P=0.03). The mean waist circumference was also greater in G1 (103.5 vs 95.7 cm; P=0.01). The prevalence of obesity was higher among G1 patients (34% vs 14.6%; P=0.016). Although more prominent in G1, the metabolic syndrome did not appear to significantly influence the clinical manifestations of DNB (65.8% vs 34.2%; P=0.07).

Discussion: Certain metabolic disturbances, notably android obesity, seem to be a factor aggravating the manifestations of DNB. Through chronic inflammation and alteration of para-sympathetic neurons, obesity-induced insulin resistance disturbs bladder muscle function. Thus, several studies highlight the interest in weight loss as a therapeutic target to improve the symptoms of DNB in obese patients with DM.

References: 1. Guiming, Liu, and Daneshgari Firouz. "Diabetic bladder dysfunction." Chinese medical journal 127.07 (2014): 1357-1364.

2. Wittig, Luc, et al. "Diabetic bladder dysfunction: a review." Urology 123 (2019): 1-6.