Incontinence is a sensitive but important topic that should not be overlooked when caring for patients living with diabetes. As a health care professional, your guidance can make a significant difference in helping patients manage leaks. When addressed early, diabetes-related urinary and fecal incontinence can be managed effectively to preserve both dignity and quality of life.
Creating a Supportive Environment for the Conversation
Because incontinence is often associated with embarrassment or shame, patients may hesitate to bring it up—even when symptoms are affecting their daily life. It’s essential to:
- Normalize the topic: Explain that diabetes can lead to incontinence and it’s not something to feel ashamed of.
- Ask open-ended questions: Instead of waiting for the patient to initiate the conversation, ask, “Have you noticed any changes in your ability to control your bladder or bowels?” or “Do you ever have trouble making it to the restroom in time?”
- Validate their experience: Reassure them that what they are experiencing is treatable.
Discuss Prevention and Lifestyle Modifications
Preventing or delaying the onset of incontinence begins with good diabetes self- management. Encourage the people you treat to:
- Maintain optimal blood glucose, blood pressure, and cholesterol levels
- Follow their eating plan
- If they use tobacco or vape quit
- Stay physically active
- Drink enough water
- Respond promptly to the urge to use the restroom
This approach helps protect nerve and blood vessel health, reducing the risk of bladder and bowel leakage from incontinence.
Building a Personalized Treatment Plan
When symptoms are present, a treatment plan can significantly reduce discomfort and complications. Offer evidence-based interventions, which may include:
- Bladder or bowel training to establish more predictable toileting routines
- Dietary adjustments, such as reducing caffeine or spicy foods
- Pelvic floor therapy, including Kegel exercises, often with referral to a pelvic health specialist
- Medication adjustments or additions
- Specialty incontinence products designed to absorb leaks, protect skin, and prevent odor
Also assess and consider:
- The person’s mobility and activity level
- Frequency and severity of leakage
- Previous or current infections or skin issues
- The patient’s comfort and preferences
Educating About the Appropriate Products
Many people use inappropriate products, such as menstrual pads or regular liners, which do not adequately manage incontinence and can worsen skin issues. Guide people toward products designed for incontinence and options that offer:
- Moisture-wicking, breathable materials
- Appropriate absorbency levels for daytime or overnight use
- Gender-specific fit when appropriate
- Barrier creams or cleansers designed to reduce irritation and infection risk
By initiating the conversation about diabetes-related incontinence, you can help the people you treat avoid complications, improve daily comfort, and support their autonomy. With your support, they can take meaningful steps toward prevention, treatment, and confident self-management.
Let your patients know that they’re not alone, and with the right tools and support, they can live well with diabetes and incontinence.