Continuing Toilet Trips After Birth

Gestational diabetes linked with overactive bladder development in premenopausal women

(RxWiki News) A common problem among pregnant women is a constant need to use the restroom. This need can turn into a more serious condition after pregnancy if these future moms are unable to keep normal blood sugar levels while baby is in the womb.

Women who developed diabetes while pregnant were nearly twice as likely to develop an overactive bladder before menopause than women who did not have diabetes, a recently published study found.

The links between overactive bladder and gestational diabetes did not seem to be connected with women's body size or if the women previously had type 1 or 2 diabetes, according to the researchers.

"Watch your blood sugar during pregnancy."

Giorgio Tettamanti, a grant-funded assistant in the Division of Obstetrics and Gynecology at the Karolinska Institutet in Stockholm, Sweden, led a team of researchers in investigating whether there were any links between overactive bladder and gestational diabetes, or high blood sugar that develops during pregnancy, in pre-menopausal women.

The study included more than 7,800 female twins born between 1959 and 1985 and who were listed in the Swedish Twin Registry. The women were about 38 years of age on average.

The twins were surveyed about their overactive bladder symptoms, including whether they had had the sudden urge to go to the bathroom or if they had lost control of their urine.

Participants reported whether they developed gestational diabetes or if they had type 1 or type 2 diabetes.

In type 1 diabetes, the body cannot produce enough insulin to properly process sugar in the blood. In type 2 diabetes, insulin produced by the body doesn't work as it should to process blood sugar.

The researchers also took note of patients' age, smoking status, education level and body mass index (BMI), a measure of height and weight. Any other information was obtained through the Inpatient Register and the Medical Birth Register.

The odds of having overactive bladder increased two-fold among women with a history of gestational diabetes compared to women without diabetes, the researchers found.

Specifically, overactive bladder occurred in 19.1 percent of women who had a history of gestational diabetes after adjusting for age, BMI and smoking status.

In comparison, overactive bladder occurred in 10.7 percent of women who did not have gestational diabetes.

Gestational diabetes could be an important risk factor for overactive bladder, even in women who do not develop diabetes later in life, the researchers said.

"In the present study we found a positive association between a history of [gestational diabetes] and [overactive bladder], which does not seem to be mediated by diabetes mellitus or BMI later in life," the researchers wrote in their report.

"As [gestational diabetes] is to some extent a preventable condition, the fact that [diabetes] could be associated with a higher risk of postpartum [overactive bladder] provides further rationale for the active prevention and management of [diabetes]." 

While nearly 1 in 8 adults has an overactive bladder, the underlying cause of the condition is unknown in the vast majority of cases, according to Tristi Muir, MD, associate professor of obstetrics and gynecology and urology at the University of Texas Medical Branch in Galveston, TX and dailyRx Contributing Expert.

"Although gestational diabetes mellitus may contribute to development of overactive bladder later in life, it is only one piece of the complex overactive bladder puzzle that sends many women running to the nearest toilet," Dr. Muir said.

"Further research into a comprehensive understanding of overactive bladder is 'urgently' needed," she said.

The authors noted that the participants could have been diagnosed with overactive bladder before having diabetes.

Common genes, environmental factors and other factors also might have affected the links between overactive bladder and diabetes.

This study was published online May 7 in BJOG: An International Journal of Obstetrics and Gynaecology.

The research was funded by the National Institute of Digestive Disorders and Kidney Diseases, the Swedish Research Council and the OAB-LUTS Competitive Grants Program by Pfizer Inc.

One of the authors is a consultant for Gynecare Scandinavia, Ethicon US and Contura A/S.

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Review Date: 
May 29, 2013