3.19 – Bladder dysfunction with diabetes mellitus

Diabetes can affect the bladder function in a number of different ways:

  • Glycosuria – glucose in the urine can irritate the bladder and cause urgency and frequency
  • Polyuria – passing more than three litres of fluid a day is a main symptom of both type 1 and type 2 diabetes
  • Detrusor hyperreflexia – the bladder muscle can become hyper-sensitive causing symptoms of an over overactive bladder dry/wet and often with nocturia
  • Detrusor hyporeflexia – the detrusor muscle can become hypo-contractile, causing incomplete bladder emptying and a hypotonic bladder
  • Diabetic neuropathy – due to damage to the somatic and autonomic nervous system, this causes decreased bladder sensation, increased bladder capacity and impaired detrusor contractility. This is known as diabetic cystopathy.  This will cause a hypotonic bladder
  • Risk of urinary tract infection (UTI) – caused by glucose in urine and residual urine in bladder

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