{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:10:30Z","timestamp":1792534230520,"version":"4.5.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":38,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Type 1 diabetes has been associated with high rates of urinary and sexual problems, but the cumulative burden and overlap of these complications are unknown. We sought to determine prevalence of urological complications in persons with type 1 diabetes, associations with clinical and diabetes-related factors, and rates of emergence, persistence, and remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This ancillary longitudinal study among participants in the Diabetes Control and Complications Trial (DCCT) and observational follow-up study Epidemiology of Diabetes Interventions and Complications (EDIC) (652 women and 713 men) was conducted in 2003 and 2010\/2011. Urinary incontinence (UI), lower urinary tract symptoms, urinary tract infection, female sexual dysfunction, erectile dysfunction, low male sexual desire, and orgasmic dysfunction were measured with validated instruments. Logistic regression determined association of complications with demographics and clinical characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of sexually active women completing the 2010\/2011 survey, 35% reported no complications, 39% had one, 19% two, 5% three, and 2% four. In men, 31% had no complications, 36% had one, 22% two, 9% three, and 3% four. Sexual dysfunction was most prevalent (42% women and 45% men) followed by UI in women (31%) and low sexual desire in men (40%). Urological complications were associated with age, BMI, and HbA1c. Remission rates ranged from 4 to 12% over the 7-year interval between surveys.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Urological complications are prevalent and frequently co-occur in persons with type 1 diabetes. Remission rates in a minority subset indicate a rationale for future studies to mitigate the onset or impact of urological complications of diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc18-0255","type":"journal-article","created":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T18:15:21Z","timestamp":1534184121000},"page":"2170-2177","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":38,"title":["Burden of Urological Complications in Men and Women With Long-standing Type 1 Diabetes in the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications Cohort"],"prefix":"10.2337","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct00360815","registry":"10.18810\/clinical-trials-gov","type":"results"},{"clinical-trial-number":"nct00360893","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3584-2323","authenticated-orcid":false,"given":"Hunter","family":"Wessells","sequence":"first","affiliation":[{"name":"Department of Urology and Diabetes Research Center, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2184-9754","authenticated-orcid":false,"given":"Barbara H.","family":"Braffett","sequence":"additional","affiliation":[{"name":"Biostatistics Center, The George Washington University, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Holt","sequence":"additional","affiliation":[{"name":"Department of Urology and Diabetes Research Center, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan M.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"NYU Winthrop Research Institute, NYU Winthrop Hospital, Mineola, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Kusek","sequence":"additional","affiliation":[{"name":"Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cowie","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney L.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Departments of Urology and Epidemiology, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna V.","family":"Sarma","sequence":"additional","affiliation":[{"name":"Departments of Urology and Epidemiology, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the DCCT\/EDIC Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2018,8,13]]},"reference":[{"key":"2022031301242546500_B1","volume-title":"National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014","author":"Centers for Disease Control and Prevention","year":"2014"},{"key":"2022031301242546500_B2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.2337\/diacare.28.1.177","article-title":"Urologic complications of diabetes","volume":"28","author":"Brown","year":"2005","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B3","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.juro.2008.10.039","article-title":"Association of urological symptoms and chronic illness in men and women: contributions of symptom severity and duration--results from the BACH Survey","volume":"181","author":"Kupelian","year":"2009","journal-title":"J Urol"},{"key":"2022031301242546500_B4","doi-asserted-by":"crossref","first-page":"664","DOI":"10.2337\/dc07-2375","article-title":"Effect of intensive glycemic control and diabetes complications on lower urinary tract symptoms in men with type 1 diabetes: Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications (DCCT\/EDIC) study","volume":"32","author":"Van Den Eeden","year":"2009","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B5","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.juro.2008.11.021","article-title":"Urinary tract infections in women with type 1 diabetes mellitus: survey of female participants in the Epidemiology of Diabetes Interventions and Complications study cohort","volume":"181","author":"Czaja","year":"2009","journal-title":"J Urol"},{"key":"2022031301242546500_B6","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.urology.2008.11.009","article-title":"Risk factors for urinary incontinence among women with type 1 diabetes: findings from the Epidemiology of Diabetes Interventions and Complications study","volume":"73","author":"Sarma","year":"2009","journal-title":"Urology"},{"key":"2022031301242546500_B7","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1016\/j.juro.2010.12.098","article-title":"Effect of intensive glycemic therapy on erectile function in men with type 1 diabetes","volume":"185","author":"Wessells","year":"2011","journal-title":"J Urol"},{"key":"2022031301242546500_B8","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1111\/j.1743-6109.2012.02664.x","article-title":"Sexual functioning and distress among premenopausal women with uncomplicated type 1 diabetes","volume":"9","author":"Dimitropoulos","year":"2012","journal-title":"J Sex Med"},{"key":"2022031301242546500_B9","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2337\/dc08-1164","article-title":"Sexual dysfunction in women with type 1 diabetes: long-term findings from the DCCT\/EDIC study cohort","volume":"32","author":"Enzlin","year":"2009","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B10","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1056\/NEJM199309303291401","article-title":"The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus","volume":"329","author":"Nathan","year":"1993","journal-title":"N Engl J Med"},{"key":"2022031301242546500_B11","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2337\/diacare.22.1.99","volume":"22","year":"1999","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B12","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0090-4295(97)00238-0","article-title":"The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction","volume":"49","author":"Rosen","year":"1997","journal-title":"Urology"},{"key":"2022031301242546500_B13","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/(SICI)1520-6777(2000)19:2<137::AID-NAU4>3.0.CO;2-G","article-title":"A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests","volume":"19","author":"Sandvik","year":"2000","journal-title":"Neurourol Urodyn"},{"key":"2022031301242546500_B14","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1016\/S0022-5347(17)36966-5","article-title":"The American Urological Association symptom index for benign prostatic hyperplasia","volume":"148","author":"Barry","year":"1992","journal-title":"J Urol"},{"key":"2022031301242546500_B15","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1056\/NEJMoa052187","article-title":"Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes","volume":"353","author":"Nathan","year":"2005","journal-title":"N Engl J Med"},{"key":"2022031301242546500_B16","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.2337\/diacare.17.11.1281","article-title":"A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy","volume":"17","author":"Feldman","year":"1994","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B17","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S0161-6420(13)38009-9","article-title":"Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7","volume":"98","author":"Early Treatment Diabetic Retinopathy Study Research Group","year":"1991","journal-title":"Ophthalmology"},{"key":"2022031301242546500_B18","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.1001\/archinte.166.21.2381","article-title":"Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey","volume":"166","author":"Kupelian","year":"2006","journal-title":"Arch Intern Med"},{"key":"2022031301242546500_B19","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/sj.ijo.0802881","article-title":"Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III)","volume":"29","author":"Rohrmann","year":"2005","journal-title":"Int J Obes"},{"key":"2022031301242546500_B20","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ypmed.2009.11.006","article-title":"Relative contributions of modifiable risk factors to erectile dysfunction: results from the Boston Area Community Health (BACH) Survey","volume":"50","author":"Kupelian","year":"2010","journal-title":"Prev Med"},{"key":"2022031301242546500_B21","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/01.AOG.0000267220.48987.17","article-title":"Urinary incontinence in women: variation in prevalence estimates and risk factors","volume":"111","author":"Minassian","year":"2008","journal-title":"Obstet Gynecol"},{"key":"2022031301242546500_B22","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1464-410X.2007.07018.x","article-title":"The future magnitude of urological symptoms in the USA: projections using the Boston Area Community Health survey","volume":"100","author":"Litman","year":"2007","journal-title":"BJU Int"},{"key":"2022031301242546500_B23","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.2337\/dc12-2109","article-title":"The long-term effects of type 1 diabetes treatment and complications on health-related quality of life: a 23-year follow-up of the Diabetes Control and Complications\/Epidemiology of Diabetes Interventions and Complications cohort","volume":"36","author":"Jacobson","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B24","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.2337\/dc15-0286","article-title":"Relationship of urologic complications with health-related quality of life and perceived value of health in men and women with type 1 diabetes: the Diabetes Control and Complications Trial\/Epidemiology of Interventions and Complications (DCCT\/EDIC) cohort","volume":"38","author":"Jacobson","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B25","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1007\/s10508-007-9290-0","article-title":"Prevalence and correlates of sexual activity and function in women: results from the Boston Area Community Health (BACH) Survey","volume":"38","author":"Lutfey","year":"2009","journal-title":"Arch Sex Behav"},{"key":"2022031301242546500_B26","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1093\/aje\/kwm356","article-title":"Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: the Boston Area Community Health (BACH) Survey","volume":"167","author":"Tennstedt","year":"2008","journal-title":"Am J Epidemiol"},{"key":"2022031301242546500_B27","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","article-title":"Prevalence of symptomatic pelvic floor disorders in US women","volume":"300","author":"Nygaard","year":"2008","journal-title":"JAMA"},{"key":"2022031301242546500_B28","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.2337\/diacare.28.7.1730","article-title":"Urinary incontinence and diabetes in postmenopausal women","volume":"28","author":"Jackson","year":"2005","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B29","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.juro.2011.10.139","article-title":"Weight loss prevents urinary incontinence in women with type 2 diabetes: results from the Look AHEAD trial","volume":"187","author":"Phelan","year":"2012","journal-title":"J Urol"},{"key":"2022031301242546500_B30","first-page":"66","article-title":"Prevalence of urinary incontinence and associated risk factors in postmenopausal women","volume":"94","author":"Brown","year":"1999","journal-title":"Obstet Gynecol"},{"key":"2022031301242546500_B31","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.juro.2016.04.071","article-title":"Glycemic control and urinary tract infections in women with type 1 diabetes: results from the DCCT\/EDIC","volume":"196","author":"Lenherr","year":"2016","journal-title":"J Urol"},{"key":"2022031301242546500_B32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1001\/archinte.166.2.207","article-title":"Predictors and prevalence of erectile dysfunction in a racially diverse population","volume":"166","author":"Saigal","year":"2006","journal-title":"Arch Intern Med"},{"key":"2022031301242546500_B33","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/bju.12728","article-title":"Metabolic syndrome and benign prostatic enlargement: a systematic review and meta-analysis","volume":"115","author":"Gacci","year":"2015","journal-title":"BJU Int"},{"key":"2022031301242546500_B34","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.juro.2016.05.117","article-title":"Advancing a comprehensive approach to the study of lower urinary tract symptoms","volume":"196","author":"Bavendam","year":"2016","journal-title":"J Urol"},{"key":"2022031301242546500_B35","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s001920200008","article-title":"Does weight loss improve incontinence in moderately obese women","volume":"13","author":"Subak","year":"2002","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"2022031301242546500_B36","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2337\/diacare.29.02.06.dc05-1781","article-title":"Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program","volume":"29","author":"Brown","year":"2006","journal-title":"Diabetes Care"},{"key":"2022031301242546500_B37","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.juro.2014.02.036","article-title":"Intensive lifestyle intervention reduces urinary incontinence in overweight\/obese men with type 2 diabetes: results from the Look AHEAD trial","volume":"192","author":"Breyer","year":"2014","journal-title":"J Urol"},{"key":"2022031301242546500_B38","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/iju.12654","article-title":"Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study","volume":"22","author":"Phelan","year":"2015","journal-title":"Int J Urol"},{"key":"2022031301242546500_B39","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.juro.2006.08.108","article-title":"The natural progression and remission of erectile dysfunction: results from the Massachusetts Male Aging Study","volume":"177","author":"Travison","year":"2007","journal-title":"J Urol"},{"key":"2022031301242546500_B40","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1111\/jsm.12483","article-title":"Predictors of sexual dysfunction incidence and remission in men","volume":"11","author":"Martin","year":"2014","journal-title":"J Sex Med"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/41\/10\/2170\/534101\/dc180255.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/41\/10\/2170\/534101\/dc180255.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T05:14:06Z","timestamp":1647148446000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/41\/10\/2170\/36653\/Burden-of-Urological-Complications-in-Men-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,13]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,8,13]]},"published-print":{"date-parts":[[2018,10,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc18-0255","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,13]]}}}