Over 1 million Australians suffer from diabetes.

2021 was a milestone year for diabetes management, marking 100 years since the discovery of insulin by Frederick Banting and Charles Best. Diabetes affects around half a billion people worldwide and insulin is used by roughly 100 million of them to regulate their blood sugar levels. Insulin is on the World Health Organisation's list of essential medicines.

Although the exact connection between diabetes and incontinence is unknown there are four ways in which diabetes can compromise a person's bladder or bowel control:

• Body Weight: This is a key risk factor, for both developing Type 2 (i.e. non-insulin dependent) diabetes and incontinence. As our pelvic floor muscles support most of our body structure, excess weight puts further strain on these muscles, thereby weakening them
• Nerve Damage: Long-term diabetes may cause damage to the nerves (neuropathy) related to the bladder and bowel, which could result in mild to severe incontinence over time
• Diabetes Medication: The medications used to control Type 2 diabetes may cause loose bowel actions
• Compromised Immunity: Diabetes affects the immune system, increasing the risk of infections. A common infection experienced by people with diabetes is UTI (urinary tract infection)

Keeping diabetes under control is the key to managing diabetes-related incontinence. There are a number of lifestyle changes that will help:

• Follow a High-fibre Diet: A healthy diet rich in dietary fibre helps avoid constipation. Adults need at least 30gm of fibre each day. Having 2 to 3 servings of fruit, 5 servings of vegetables and fibre-rich cereals and breads will help provide the necessary daily intake required
• Stay Hydrated: Water is always a good choice, but other drinks may actually cause you to go more simply because of what’s in them. Minimise caffeinated, sugary and carbonated drinks and decrease or eliminate alcohol consumption. All of these have been known to irritate the bladder. Recommended daily fluid intake varies for each person and factors such as weather, exercise and overall health conditions should be considered
• Perform Pelvic Floor Exercises: Perform regular pelvic floor exercises as recommended by a physician to strengthen pelvic floor muscles and provide additional control over bowel movements
• Practice Good Toilet Habits: Everyone should visit the toilet when their bladder feels full, and they should allow enough time to completely empty their bladder and bowel

Note: all suggestions are general in nature - please consult your medical practitioner for advice specific to you.