Highlights
- •The present study included 1,357 women with and 6,785 women without type 1 diabetes from 268 gynecologists in Germany.
- •T1D was significantly associated with acute vulvitis and cystitis.
- •Moreover, T1D was significantly associated with urinary incontinence, absent, scanty and rare menstruation.
Abstract
Aim
Type 1 diabetes can lead to various long-term complications including macro- and microvascular
disorders and osteoporosis. However, published data on the association between type
1 diabetes (T1D) and urinary system and genital tract disorders is limited. The aim
of this work was to estimate the prevalence and incidence of urinary system- and genital
tract disorders among women with T1D treated in gynecological practices in Germany.
Methods
This retrospective cohort study included women aged 16 years or older with T1D diagnosis
between January 2015 and December 2018 from 268 gynecological practices in Germany
(IMS Disease Analyzer database). T1D patients were matched 1:5 by age and physician
with non-diabetic patients. The main outcome of the study was the prevalence of different
urinary system, pelvic organ and genital tract disorders documented between the first
documentation of T1D diagnosis and the last outpatient visit. All study disorders
were included as dependent variables in multivariate logistic regression models, while
T1D was applied as an impact variable. In each model, the effect of T1D on the defined
disorder was adjusted for all other study disorders.
Results
The present study included 1357 women with and 6785 women without T1D (mean age 45.6
years). T1D was significantly associated with acute vulvitis (OR: 2.12 (95% CI: 1.56–2.90),
other specified urinary incontinence (OR: 1.64 (95% CI: 1.19–2.26), acute cystitis
(OR: 1.46 (95% CI: 1.10–1.95), and absent, scanty and rare menstruation (OR: 1.37
(95% CI: 1.13–1.67).
Conclusion
These findings may have implications for the future care of women with T1D. Firstly,
the focus should not be on diabetes management alone, but also on identifying and
handling additional associated comorbidities including urinary system and genital
tract disorders. Secondly, the data suggest that patients with T1D should be asked
specifically about symptoms they may be experiencing that are related to the associated
disorders identified.
Keywords
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Article info
Publication history
Published online: September 23, 2020
Accepted:
September 10,
2020
Received in revised form:
September 4,
2020
Received:
July 28,
2020
Identification
Copyright
© 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
