{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:30:26Z","timestamp":1774686626461,"version":"3.50.1"},"reference-count":25,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":4475,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine the prevalence and risk factors for urinary incontinence among different racial\/ethnic groups of overweight and obese women with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Cross-sectional analysis of baseline data from the Action for Health in Diabetes (Look AHEAD) study, a randomized clinical trial with 2,994 overweight\/obese women with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Weekly incontinence (27%) was reported more often than other diabetes-associated complications, including retinopathy (7.5%), microalbuminuria (2.2%), and neuropathy (1.5%). The prevalence of weekly incontinence was highest among non-Hispanic whites (32%) and lowest among African Americans (18%), and Asians (12%) (P &amp;lt; 0.001). Asian and African American women had lower odds of weekly incontinence compared with non-Hispanic whites (75 and 55% lower, respectively; P &amp;lt; 0.001). Women with a BMI of \u226535 kg\/m2 had a higher odds of overall and stress incontinence (55\u201385% higher; P &amp;lt; 0.03) compared with that for nonobese women. Risk factors for overall incontinence, as well as for stress and urgency incontinence, included prior hysterectomy (40\u201380% increased risk; P &amp;lt; 0.01) and urinary tract infection in the prior year (55\u201390% increased risk; P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among overweight and obese women with type 2 diabetes, urinary incontinence is highly prevalent and far exceeds the prevalence of other diabetes complications. Racial\/ethnic differences in incontinence prevalence are similar to those in women without diabetes, affecting non-Hispanic whites more than Asians and African Americans. Increasing obesity (BMI \u226535 kg\/m2) was the strongest modifiable risk factor for overall incontinence and stress incontinence in this diverse cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc09-0516","type":"journal-article","created":{"date-parts":[[2009,6,2]],"date-time":"2009-06-02T01:42:41Z","timestamp":1243906961000},"page":"1391-1397","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":63,"title":["Prevalence and Risk Factors for Urinary Incontinence in Overweight and Obese Diabetic Women"],"prefix":"10.2337","volume":"32","author":[{"given":"Suzanne","family":"Phelan","sequence":"first","affiliation":[{"name":"Kinesiology Department, California Polytechnic State University, San Luis Obispo, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alka M.","family":"Kanaya","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, University of California San Francisco (UCSF), San Francisco Veterans Affairs Medical Center, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslee L.","family":"Subak","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics, Gynecology and Reproductive Sciences, Urology and Epidemiology, UCSF Women's Health Clinical Research Center, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia E.","family":"Hogan","sequence":"additional","affiliation":[{"name":"Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Espeland","sequence":"additional","affiliation":[{"name":"Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rena R.","family":"Wing","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn L.","family":"Burgio","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham and Department of Veterans Affairs, Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicki","family":"DiLillo","sequence":"additional","affiliation":[{"name":"Department of Psychology, Ohio Wesleyan University, Delaware, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy A.","family":"Gorin","sequence":"additional","affiliation":[{"name":"Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delia S.","family":"West","sequence":"additional","affiliation":[{"name":"Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics, Gynecology and Reproductive Sciences, Urology and Epidemiology, UCSF Women's Health Clinical Research Center, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2009,6,1]]},"reference":[{"key":"2022031302520887600_B1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1532-5415.1995.tb05806.x","article-title":"Difficulty with holding urine among older persons in a geographically defined community: prevalence and correlates","volume":"43","author":"Wetle","year":"1995","journal-title":"J Am Geriatr Soc"},{"key":"2022031302520887600_B2","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0022-5347(05)00039-X","article-title":"Differences in prevalence of urinary incontinence by race\/ethnicity","volume":"175","author":"Thom","year":"2006","journal-title":"J Urol"},{"key":"2022031302520887600_B3","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1002\/nau.20635","article-title":"A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women","volume":"27","author":"Hunskaar","year":"2008","journal-title":"Neurourol Urodyn"},{"key":"2022031302520887600_B4","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF02765589","article-title":"The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry","volume":"8","author":"Noblett","year":"1997","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"2022031302520887600_B5","unstructured":"Minnesota Evidence-based Practice Center. 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