ABSTRACT
This chapter reviews the epidemiology of voiding symptoms in older persons with diabetes mellitus (DM); the pathophysiologic impact of DM on voiding; DM-related factors that affect toileting and micturition; asymptomatic bacteriuria and urinary tract infections (UTI); and assessment and treatment of urinary incontinence (UI) in older persons with DM. Congestive heart failure from DM-related coronary artery disease can cause pedal edema and nocturnal polyuria, leading to the nocturia and nighttime UI. The thiazolidinediones, as well as gabapentin and pregabalin, may cause pedal edema and congestive heart failure, thereby leading to nocturia and nighttime UI. Diabetic neuropathy, associated Charcot joints, peripheral vascular disease, and amputation can impair mobility, which is a key determinant of UI in older persons. Diabetics with a UTI are more likely to develop bacteremia, pyelonephritis, papillary necrosis, renal abscess, acute renal failure, and metastatic complications such as septic arthritis, osteomyelitis, and endopthalmytitis.
