Pain when urinating in diabetes mellitus

Causes and symptoms of urethritis in diabetes mellitus in men and women

In diabetes mellitus, carbohydrate metabolism is disrupted, therefore the functioning of all organs and systems of the body, including the genitourinary system, is disrupted.
Urinary tract infection becomes a urological problem. Bacteria from the outside penetrate into the urethra through sexual contact and from the digestive system, as well as viruses, which leads to the development of urethritis - an acute or chronic inflammatory disease. Urine is removed from the bladder through the urethra, and if there are pyogenic microorganisms in it, urethritis is most often diagnosed in young people.

Urethritis is a disease of the urinary tract in men and women with diabetes

Treatment

Treatment of urinary incontinence in diabetes mellitus directly depends on the form of the disease and the reasons that caused it. There are numerous herbal remedies that help improve bladder function. However, it will be possible to eliminate the problem only if the person’s true illness is completely or as much as possible eliminated.

If you have diabetes, to eliminate involuntary urination, it is recommended to follow a diet developed by your doctor. Eliminate diuretic products and coffee from your diet. Eliminate diuretics from prescribed medications and try to lose excess weight.

In addition, traditional treatment involves the patient attending exercise therapy and performing specific exercises that help strengthen the bladder muscles. At an advanced stage of the disease and complications, a specialist may prescribe glucose-lowering medications. Their use will help reduce the load on the kidneys and reduce the production of urine to eliminate glucose.

Among traditional medicines, lingonberries and rose hips have good restraining properties. Daily consumption of infusions from these berries helps reduce the level of urine produced. Other useful infusions are prepared from nettle and dandelion roots. On sale you can find special preparations against frequent urination.

Important: before taking medication or drinking herbal infusion, it is recommended to consult with your doctor; self-medication is unacceptable!

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Urethritis - what it happens

Both male and female urethritis can be acute, chronic, nonspecific and specific, as well as bacterial, candidiasis and trichomonas. This urological disease is associated with the occurrence of inflammation in the wall of the urethra.

In men, urethritis is more severe than in women due to the anatomical features of the urinary system. In women, the urethra is wide and short (1-2 cm), so the infection goes directly to the bladder. Swelling of the canal mucosa appears, but due to its width, the outflow of urine is not significantly impaired.

In men, the urethra reaches 0.8 mm in width and up to 22 cm or more in length; it has bends, so pathogens remain in it longer. In addition, a wide prostatic part of the canal, 3-4 cm long, passes through the thickness of the prostate.

A narrow membranous part of the canal begins from the prostate gland, it does not stretch, has a length of 1.5-2 cm and extends to the beginning of the penis. The movable spongy part of the canal is already inside the genital organ.

With inflammatory swelling of the mucous membrane of all parts of the urethra, the outflow of urine is significantly impaired, and acute urinary retention is possible.

Inflammatory process with infectious lesions of the urethra in men

Causes

Non-infectious urethritis occurs due to:

irritation of the mucous membrane with small stones in urolithiasis of the kidneys,
trauma to the canal during endoscopic cystoscopy, masturbation, during which some men imprudently insert various objects into the lumen of the canal,
malignant neoplasms in the canal, which lead to the development of inflammation,
allergic diseases and diabetes, which cause itching, due to which scratching occurs and infectious urethritis begins,
narrowing of the canal due to tumors, prostatitis, benign pancreatic hyperplasia, which leads to stagnation of urine and inflammation,
stagnation of blood in the pelvic veins.

Nonspecific infectious urethritis with an inflammatory process in the urethra develops with the penetration of staphylococci, streptococci, E. coli and other microorganisms. When herpes viruses penetrate, viral infectious urethritis is diagnosed.

Specific infectious urethritis can be gonorrheal, trichomonas, candidiasis, mycoplasma, chlamydia. The route of infection is sexual or hematogenous: through the flow of blood or lymph from foci of inflammation in other organs.

Inflammation in the urethra also develops when the body's defenses are reduced due to serious illness, fasting, poor nutrition, vitamin deficiency, stress, alcoholism, with existing chronic inflammatory foci in the body, concomitant diseases of the genitourinary organs, hypothermia and non-compliance with personal hygiene rules.

Causes of the disease

Doctors identify two main reasons why patients experience increased urination. In particular, the body of a sick person tries to remove excess glucose by removing fluid. It is worth noting that with a high concentration of sugar, the kidneys stop passing fluid.

At the same time, the body requires a lot of water, because it is needed to eliminate excess glucose. In this regard, people become very thirsty, and patients begin to drink a lot. Naturally, this means you have to visit the toilet frequently to empty your bladder. Moreover, most of all a person experiences such a need precisely at night, when he needs to sleep.

It should be noted that as pathology develops, nerve cells begin to be affected. As a result, the human body can no longer fully control the tone of the bladder. Such a failure is irreversible and cannot be eliminated even with the help of a special diet and physical activity. It should be noted that diabetics have an increased risk of contracting bladder infections, so it is important to take precautions.

Naturally, with frequent urination in diabetes, a person will think about how to correct the situation. He can be advised to definitely contact a medical specialist, because it will be difficult to solve the problem on his own.

Symptoms

In the first stages of the incubation period with nonspecific urethritis, patients do not feel much discomfort; in the presence of a specific pathology, men complain of severe symptoms after a few hours or 1-2 days.

The symptoms of both types of urethritis: non-infectious and non-specific infectious are almost the same and manifest themselves:

itching, burning and other unpleasant sensations,
periodic aching pain under the pubis,
in men - urinary disorders,
hematuria - blood in the urine,
sticking of the canal opening in the morning due to discharge from the urethra.

Symptoms of specific urethritis are given in Table 1:

In women, when urinating in the acute stage, pain and pain are noted, in the chronic stage they may not be present, so they are diagnosed based on the results of smears of discharge and examination.

In men, the inflammatory process manifests itself in the area of the external opening of the canal:

burning, itching, pain when urinating,
a feeling of pins and needles and delays in the outflow of urine,
white-gray discharge,
impurities of blood in the ejaculate.

Women do not feel anything in 25-30% of cases or complain of a burning itching in the urethra and external genitalia.

The symptoms in men and women are approximately the same, manifested by pain, burning, itching when urinating, pinkish-whitish discharge of a viscous and thick consistency. In men, the glans and foreskin become inflamed, which leads to the development of balanoposthitis. Initially, the development of inflammation occurs in a subacute form.

In men, at first the symptoms are similar to gonorrhea, then the disease takes a chronic course, and the symptoms disappear altogether. They may experience a slight burning and itching when urinating, and a drop of mucous discharge in the morning.

Women complain of discomfort due to mild itching and scanty discharge from the urethra. In the absence of symptoms, many women do not go to the doctor or receive medical care at all, which then affects their health and the health of their sexual partners.

After 3-4 weeks, the disease may subside on its own, without medical treatment, but under favorable conditions it may recur again.

It is important to know. With diabetes, in addition to sharp pain symptoms during urination, pain appears along with a burning sensation in the pubic area, radiating to the lower back and sacrum. The urge to urinate becomes frequent, especially at night. Cutting pain in the upper part of the penis and pain in the perineum. When an elevated temperature occurs, patients become weaker and quickly tire. This is a good reason to consult a doctor for examination and necessary treatment.

Cutting and pain when urinating

Manifestations of polyuria in diabetes

With the development of diabetes mellitus, the appearance of symptoms such as increased urine output and constant thirst, which is not relieved by taking a significant amount of liquid, is the first signal of insulin deficiency.
In type 1 diabetes, these symptoms appear suddenly and rapidly increase if insulin treatment is not started in time. With type 2 diabetes, there may be a gradual increase in dry mouth and a slight increase in urination, to which patients may not respond.

Frequent urination in diabetes bothers patients regardless of the time of day, and more urine may be released at night than during the day. There is excessive urination and loss of continence at night. The appearance of enuresis is observed in children, but with diabetes mellitus it occurs in older age groups.

In addition to the typical symptoms of diabetes - weakness, thirst, hunger - with frequent urination, women experience itching in the genital area and thrush. This is due to anatomical features and the presence of glucose in the urine, which serves as a good environment for the development of fungi.

A decrease in the protective properties of the mucous membranes and disorders of the immune system lead to cystitis. Exacerbations of bladder inflammation are accompanied by the following symptoms:

Pain and cutting when urinating.
Temperature increase.
Discharge of cloudy urine.
Frequent and painful urge to urinate.

The course of cystitis in type 2 diabetes is characterized by frequent recurrence, longer duration and severity of clinical symptoms.
Irritation of the glans penis by urine in men leads to balanoposthitis, which most often has a chronic and persistent course in diabetics. The development of prostate adenoma against the background of diabetes mellitus aggravates the disturbance of urinary excretion. The urge to urinate becomes frequent and strong, especially at night. As the enlargement of the prostate gland progresses, it compresses the bladder, which leads to a delay in urine output.

Urinary incontinence in diabetes mellitus and adenoma is associated with increased urine production and bladder overflow. With prostate adenoma, diabetic damage to the bladder progresses - cystopathy, which affects men with severe uncompensated diabetes, most often insulin-dependent.

In this case, the bladder loses the ability to carry out normal contractions, and patients do not feel its fullness.

The second type of diabetes in men is accompanied by an inflammatory process in the prostate gland. The incidence of prostatitis is associated with impaired metabolism and greater susceptibility to inflammatory reactions. With the addition of prostatitis, disturbances in urinary excretion intensify.

In young children, polyuria is more difficult to detect, especially if a diaper is used. Therefore, parents should be wary of increased thirst, anxiety and lethargy. Despite a good appetite, such babies do not gain weight well.

A manifestation of progressive diabetes mellitus is the smell of acetone from the mouth or urine.

Diagnosis of urethritis

The inflammatory process in the urethra is determined by research:

general analysis of urine and blood - they determine the concentration of leukocyte cells in the urine and blood,
smears of discharge from the urethra. Microscopic examination reveals the content of leukocytes, bacteriological examination of smears and urine determines the sensitivity of pathogens to antibiotics,
PRC - polymerase chain reaction to identify the causative agent of infectious urethritis and herpes virus,
three-glass test to establish the localization of the inflammatory process and diagnosis between urethritis and diseases such as cystitis, prostatitis, pyelonephritis,
from the inside of the urethral mucosa using urethroscopy: dry and irrigation (with supplied liquid),
Ultrasound of the pelvis,
canal and bladder with a radiopaque substance during voiding cystourethography,
urethra, canal and bladder with special equipment - urethrocystoscope.

Diabetes and urinary tract infections

First, a minute of anatomy. Urine is formed in the kidney, then through a thin tube, the ureter, it enters the bladder. When a sufficient amount of urine accumulates in the bladder, with our direct effort, urine is removed from the body through tube number two - the urethra. In women, the urethra is short and located close to the vagina, which makes it easier for infections to enter the urinary tract. Because of this anatomical feature, urinary tract infections (UTIs) are 10 times more common in women than in men.

What are the types of urinary tract infections?

Lower urinary tract infections are inflammation of the urethra (urethritis) or bladder (cystitis). Symptoms: painful urination, urinary retention or frequent urge to urinate, pain in the lower abdomen.
Upper urinary tract infections are inflammation of the kidney tissue (pyelonephritis). Symptoms: fever, lower back pain.

How do urinary tract infections occur in people with diabetes?

In people with diabetes, urinary tract infections are more common than in people without diabetes; for example, the risk of pyelonephritis in diabetes is 4 times higher. There are reasons for this:

Reduced activity of the immune system;
Incomplete emptying of the bladder, which occurs with autonomic neuropathy. As a result, microorganisms have enough time to successfully grow and multiply in the urinary tract;
Glucose, often found in urine in diabetes mellitus, is an excellent food for infectious agents. For type 2 diabetes, SGLT-2 inhibitors are used - medications that lower blood sugar by excreting glucose in the urine. The use of these drugs has been shown to slightly increase the risk of lower urinary tract infections. Therefore, SGLT-2 inhibitors are not recommended for people with chronic UTIs.

In addition to diabetes and being female, risk factors for developing UTIs include:

Use of urinary catheters
Elderly age
Diabetic neuropathy
Diabetic nephropathy

For women, additional risk factors are identified:

Sexual activity, new sexual partner, use of spermicides as a contraceptive
Previous urinary tract infections
Maternal urinary tract infections
The onset of menopause

UTIs can be acute and resolve completely with timely treatment. In some cases, they can become chronic with periodic exacerbations. In the absence of timely treatment, a very weak immune system or a very strong microbe, an infection in the urinary tract can become complicated. It is important to know that only uncompensated diabetes mellitus is a risk of complicated UTI. Here's another reason to keep your glucose levels under control!

To make a diagnosis you need to:

Assess existing symptoms: in diabetes mellitus, along with typical symptoms, inexplicably high or low blood sugar may be a sign of an incipient infection;
General urine test: more than 10 leukocytes detected by the doctor in 1 field of view of the microscope will indicate a high probability of infection. Let me remind you that before taking a urine test, preparation is required - a thorough hygienic shower of the groin area with soap and obtaining a medium portion of urine. Otherwise, bacteria from the skin may enter the urine, resulting in unnecessary treatment.
Urine culture, which will show the growth of a sufficient number of the culprits of the infection on a special nutrient medium and will determine which antibiotics these microorganisms are sensitive to.
Ultrasound of the kidneys if an upper urinary tract infection is suspected.

Additional examination methods may be required in case of complicated disease.

To treat or not to treat?

Urinary tract infections are treated with antibiotics, which are excreted in the urine and work effectively in the urinary tract. Most often this is fosfomycin, drugs from the group of fluoroquinolones and nitrofurans. In order to begin treatment, it is enough to have typical symptoms and detect leukocytes in a general urine test. Of course, only your doctor, preferably a urologist, can choose the appropriate antibiotic. In the case of chronic UTI, the urologist selects an antibiotic regimen to prevent exacerbations of the disease.

If UTI is complicated, surgical treatment may be required.

Should I be afraid of asymptomatic leukocyturia?

And finally, a few words about asymptomatic bacteriuria. This is a condition (not a disease!) in which there are no symptoms of UTI, but white blood cells in the urine are elevated, and potential pathogens grow in decent numbers when cultured in urine. Up to 27% of people with diabetes experience asymptomatic bacteriuria. But does this condition require treatment?

According to research, treatment of asymptomatic bacteriuria does not reduce the risk of developing UTIs and their complications, as well as the likelihood of diabetic nephropathy in people with well-controlled diabetes. On the contrary, the asymptomatic residence of bacteria in the urinary tract likely prevents the colonization of more aggressive microorganisms.

Treatment of asymptomatic bacteriuria is also not recommended in old age, in cases of bladder emptying disorders and before operations (except for operations on the urinary tract).
It is important to understand that the abuse of antibacterial drugs increases the resistance of bacteria to treatment and can lead to more severe infectious diseases in the future. The exception is pregnancy. Treatment of asymptomatic bacteriuria during pregnancy reduces the risk of developing urinary tract infections. Therefore, most experts, including the British National Institute for Excellence in Care (NICE) and the American College of Obstetricians and Gynecologists (ACOG), recommend that pregnant women be screened for asymptomatic bacteriuria, followed by treatment with antibacterial drugs.

Damage to the bladder and kidneys in diabetes

The bladder in diabetes mellitus is affected by the development of autonomic neuropathy.
Normally, filling the bladder with 300 ml of urine causes the urge to urinate, but with cystopathy, patients do not feel it even with 500 ml. At night there is no urination, despite the bladder being full, urinary incontinence appears. The bladder cannot empty completely, the urine stream is weak, and urination becomes prolonged. Between visits to the toilet, patients complain of urine leakage. With a long course, cystopathy is complicated by complete urinary incontinence.

The development of kidney damage in diabetes leads to nephropathy associated with the destruction of the filtration apparatus of the kidneys and renal vessels. This complication of diabetes causes kidney failure and poisoning of the body with toxins that the kidneys cannot cope with.

Signs of diabetic nephropathy are:

Increased volume of urine.
The appearance of protein in the urine.
Nausea, vomiting.
Increased blood pressure.
Increased itching of the skin.
Headache.
Progressive weakness.

As the condition worsens, the glomerular filtration rate decreases so much that to save the lives of patients, they are connected to hemodialysis.

Cystitis in diabetes: causes of manifestation and course features

Against the background of diabetes mellitus, carbohydrate metabolism disorders appear in the patient's body. Such changes have a negative impact on the functioning of various organs and systems, and they also affect urinary functions.

In diabetes, cystitis is diagnosed quite often. Female representatives are considered to be at risk for this pathology due to the structural features of the urinary duct. Quite often, the pathology is diagnosed in elderly patients; this predisposition is due to the inability to completely empty the bladder.

Sugar accumulates in the patient’s body, which acts as a rather favorable “soil” for the proliferation of various pathogens that stimulate the development of the disease.

Causes of frequent urination in diabetes

The appearance of polyuria in diabetes is associated with an increase in blood glucose levels. At the same time, the osmotic pressure in the kidney tubules increases, since glucose molecules attract fluid when excreted.

One gram of glucose removes 20-40 ml of fluid from the body, that is, the more glucose there is in the blood, the more water is lost. In diabetic patients, the ability to reabsorb it is reduced. In severe cases of the disease, urine output can reach 10 or more liters per day.

Nature of the lesion

Bladder dysfunction is common in diabetes mellitus. Symptoms accompanying the pathology can significantly worsen the patient’s quality of life. A complication of diabetes mellitus is damage to the nerves that control the function of the urinary system.

The pathological condition is characterized by several changes:

increased frequency of the urge to urinate;
reduction in the daily volume of urine excreted;
partial or complete inability to excrete urine.

Attention! Against the background of diabetes mellitus, overactive bladder syndrome develops, which is classified as a neurogenic lesion.

Often, with both types of diabetes, infectious lesions of the bladder or other parts of the excretory system are diagnosed. Often the infectious process spreads to the urinary system from the gastrointestinal tract.

In the case of the development of a pathogenic focus in the urethra, urethritis is diagnosed, which has the ability to develop into cystitis. Further spread of the process is even more dangerous - the development of glomerulonephritis and pyelonephritis is possible. Chronic inflammatory processes often develop.

Types of pathological urinary incontinence

Before prescribing tablets for urinary incontinence, it is necessary to establish the cause of the pathology.
Each individual case requires individual therapy that will bring the best results. There are the following types of frequent uncontrolled urination: If the problem was caused by the presence of inflammatory processes or other pathologies, the doctor should prescribe the patient individual complex drug therapy, which involves taking antidepressants and other medications.

Incontinence caused by diseases of the genitourinary system, caused by diabetes mellitus or various injuries to the spinal column.
Urgent incontinence. Diagnosed in 15 of all patients. It occurs due to too high pressure in the bladder and low pressure in the urethra. A distinctive feature of the pathology is a sharp, difficult to control urge to urinate, most often ending in the spontaneous release of urine.
Approximately half of patients suffer from involuntary stress urination, which occurs during coughing, sneezing, laughing, or high physical activity. Such disorders are most often associated with an insufficient amount of collagen in the ligaments located in the pelvic area.

Causes of cystitis in diabetes mellitus

The urinary system is quite vulnerable to various pathogenic pathogens. Against the background of decreased immunity, pathogenic microorganisms successfully develop in this environment, provoking the manifestation of morphological changes in tissues and mucous membranes.

Cystitis is an infectious disease affecting the mucous membranes of the bladder.

Attention! Why does cystitis occur frequently in diabetics? The tendency to such damage is due to a decrease in the protective properties of the body. The penetration of infection is not as dangerous for a healthy person as for a diabetic.

No less favorable factor determining the development of the pathological process is the presence of sugar in the urine.

The list of provocateurs of the inflammatory process can be presented as follows:

Cystitis in diabetes can be severe, causing the manifestation of various symptoms. In some cases, the pathology has a latent course. The symptoms of the disease are similar to the manifestations of the disease in a healthy person.

A feature of the course is the high risk of chronicity of the pathological process, which is why you need to consult a specialist when the first symptoms appear. Delays in such a case are unacceptable.

Medical nutrition

When the kidneys fail, nutrition alone will not help, but in the early stages or to prevent kidney problems, a diabetic kidney diet is actively used. Dietary nutrition will help normalize glucose levels and maintain the patient’s health. The diet should not contain a lot of proteins. It is recommended to eat the following foods:

porridge with milk;
vegetable soups;
salads;
fruits;
heat-treated vegetables;
dairy products;
olive oil.

The menu is developed by a doctor. The individual characteristics of each organism are taken into account. It is important to adhere to salt consumption standards; sometimes it is recommended to completely abandon this product. It is recommended to replace meat with soy. It is important to be able to choose it correctly, since soybeans are often genetically modified, which will not be beneficial. Glucose levels should be monitored, since its influence is considered decisive for the development of pathology.

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Symptoms

Against the background of bladder inflammation, various urological pathologies often develop. This is due to a decrease in general immunity in the diabetic’s body, that is, there are no obstacles to the spread of inflammatory processes throughout the body.

Attention! Instructions providing treatment for cystitis in diabetes and other urological pathologies require the patient to promptly contact a specialist. Inflammatory processes rapidly spread in the body and can provoke the development of lesions in various organs.

The list of symptoms characteristic of the disease can be presented as follows:

urinary incontinence;
excretion of urine in small portions;
frequent but false urge to go to the toilet;
presence of blood in the patient’s urine;
cloudy urine;
sensation of pain and burning when urinating;
abdominal pain;
temperature increase.

Antidepressants

Urinary incontinence in women and men is often treated with tablets that have a metabolic effect (antidepressants). Such drugs are used mainly in cases where loss of control over urine output was provoked by a stressful situation. Their regular intake has a beneficial effect on local and general metabolism, and also accelerates the synthesis of important proteins in the body and protects tissues from various toxins. The most popular antidepressants used to treat incontinence are:

Tablets for urinary incontinence are not prescribed to older women in cases where the ligaments and muscle tissue surrounding the bladder have not completely lost their tone or their integrity is not seriously impaired.

How to identify a complication?

Diabetic cystopathy is often diagnosed in patients with diabetes mellitus. The disease is characterized by the development of neurogenic damage to the bladder; often there is a disruption in the nutrition of nerve receptors, and the process of regulating the activity of the affected organ is disrupted.

The disease is characterized by a slow course (develops within 10-15 years after the onset of diabetes).

At the initial stages, the following changes can be observed:

the size of the bladder increases;
there is residual fluid in the bladder;
the stream loses pressure, its weakness is visible;
the number of urges is significantly reduced.

If timely therapy is not available, there is a possibility of developing sepsis, pyelonephritis or azotemia.

Diagnostics

collecting the patient's medical history;
bacteriological culture of urine for flora;
analysis to determine the body's sensitivity to antibiotics;
general urine analysis;
bladder examination;
Ultrasound of the kidneys and pelvic organs;
retrograde pyelography;
CT;
cytoscopy.

The listed diagnostic methods provide an accurate determination of the required diagnosis. The patient can undergo examination in a private or public clinic. In a private clinic, the price of the listed procedures is slightly higher, but the level of comfort for the patient is increased.

Diagnostics

Since loss of urinary control can accompany various diseases, patients with diabetes mellitus and dysuric disorders are prescribed a comprehensive examination. It includes the following tests and diagnostic procedures:

physical examination;
taking anamnesis;
analysis of data from the urination diary;
urodynamic study;
Ultrasound of the bladder and kidneys;
general blood and urine tests, etc.

Depending on the patient’s condition and the nature of the complaints, the doctor may recommend other forms of examination.

Treatment of cystitis

Treatment of cystitis in diabetes mellitus is complicated. The drug regimen involves the use of drugs with pronounced antimicrobial activity.

Antibacterial components for treatment are selected by a doctor who has studied the characteristics of diabetes and cystitis in a particular patient. Antispasmodics are used to eliminate pain symptoms.

Attention! When determining a treatment regimen for a pathology, correction of the insulin administration regimen is often required.

The main principles of treating cystitis in diabeticsWhat is used?DescriptionCharacteristic photo

Antibacterial drugs

The list of antibacterial agents used can be presented as follows:

It is preferable to use agents belonging to the group of fluoroquinolones.

The duration of the course of therapy is 7-10 days.

The list of such drugs can be presented as follows:

The medicines contain vitamin C, which ensures the activation of immune functions.

The list of contraindications to the use of the compositions is small, but before using the products it is worth consulting with a specialist.

Diet The treatment regimen requires daily consumption of fermented milk products. Nutritionists explain this by saying that such foods help restore intestinal microflora. The patient should drink a sufficient amount of clean water, as well as fruit drinks and berry decoctions.

Treatment

Therapy for incontinence in diabetes mellitus is determined by the form of the pathology and the reasons that caused it. In most cases, an integrated approach is successful. Your doctor may recommend following a diet that eliminates foods and drinks with a diuretic effect. In addition, it is advisable to take measures to control excess weight. As part of complex treatment, the doctor may prescribe physical therapy (exercises to strengthen the muscles of the pelvic organs). To reduce the load on the kidneys and reduce the volume of urine produced, in some cases, hypoglycemic drug therapy is used. These and other medications are used strictly according to the doctor’s recommendation in the dosage prescribed by him.

The question regarding problems with urinary incontinence in patients with diabetes mellitus still remains open. Researchers from different countries are studying this problem by conducting various surveys and studies. After many years of study, it was found that urinary incontinence in diabetes is of an urgent nature.

Frequent urination in diabetes can occur not only in middle-aged and older people, but also in young children. If a child runs to the toilet more than 6 times a day, and there is no reason for this, it is worth consulting with an endocrinologist about him.

Important: an irresponsible attitude towards a child’s health can lead to disappointing consequences – the development of enuresis.

Questions for a specialist

Hello Tatiana. First of all, remember that at present you are responsible not only for your health, but also for the health of your unborn child.

Why did you decide that the doctor wants to harm you and will immediately prescribe antibacterial therapy? You need to undergo an examination, the results of which will help make an accurate diagnosis. No doctor will decide at random which remedy will be effective. Urgently visit a gynecologist, itching of the genitals is not always a symptom of cystitis; there may be some kind of infection.

Causes and symptoms of urethritis in diabetes mellitus in men and women

In diabetes mellitus, carbohydrate metabolism is disrupted, therefore the functioning of all organs and systems of the body, including the genitourinary system, is disrupted. Urinary tract infection becomes a urological problem. Bacteria from the outside penetrate into the urethra through sexual contact and from the digestive system, as well as viruses, which leads to the development of urethritis - an acute or chronic inflammatory disease.

Urine is removed from the bladder through the urethra, and if there are pyogenic microorganisms in it, urethritis is most often diagnosed in young people.

Urethritis is a disease of the urinary tract in men and women with diabetes

How to treat diabetic nephropathy?

Kidney treatment for diabetes mellitus begins after diagnosis. The essence of therapy is to prevent further development of pathological processes and delay the progression of the disease. All diseases that develop against the background of diabetes cannot be treated without controlling blood sugar levels. It is important to constantly monitor your blood pressure. If the patient is on a diet, listen to the doctor’s recommendations; he may not encounter diabetic nephropathy at all, since it takes at least 6 years from the onset of diabetes for the pathology to develop. At this stage, diet alone may be sufficient.

Diabetic damage to the kidney vessels is eliminated with diuretics, beta blockers, blood pressure normalizers, and calcium antagonists.

As the disease progresses until the kidneys fail, treatment with pharmaceutical drugs is often sufficient. ACE inhibitors are used. These drugs lower blood pressure. They are good protectors of the heart and kidneys. It is better to use drugs with prolonged effects. Treatment of nephropathy in diabetes mellitus is sometimes also carried out:

diuretics;
calcium antagonists;
combination drugs for hypertension;
angiotensin blockers;
beta blockers.

If the disease is diagnosed in advanced stages, diabetic nephropathy is treated with hemodialysis or peritoneal dialysis. These procedures are carried out if the functions of the organ cannot be preserved. In any case, such patients need a kidney transplant, after which almost all patients experience complete recovery from renal failure.

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Urethritis - what it happens

With inflammatory swelling of the mucous membrane of all parts of the urethra, the outflow of urine is significantly impaired, and acute urinary retention is possible.

Inflammatory process with infectious lesions of the urethra in men

Why do diabetics urinate more often?

People with high blood sugar may experience frequent urination, which accompanies diabetes both in the initial stages and with advanced pathology up to type 2. This phenomenon has a logical explanation if you understand the specifics of the disease and possible complications.

Causes of frequent urination

It is considered normal to empty the bladder 6-10 times a day, with the exception of days when the need for fluid was greater than usual. If the desire to urinate exceeds the norm (in diabetic patients it can reach up to 40 times) and this happens constantly, it means that pathological processes are occurring in the body.

Considering frequent urination in diabetes, the following reasons are highlighted:

Increased glucose levels. With increased blood sugar, the body tries to remove the excess and partially succeeds, but glucose adds more water molecules, which ultimately leads to dehydration. The response is an emerging thirst, which can also be combined with increased appetite.
Nervous type disorders. Conventionally, this process can be described as loss of control over urination. Nerve impulses do not transmit signals correctly to the brain, and bladder overactivity, incontinence, and other related problems may occur.
Complications of diabetes or acquired diseases of the genitourinary system. Together with glycemia, inflammatory diseases can occur in the body, causing polyuria. This includes cystitis, pyelonephritis, sexually transmitted infections.

How to find out why frequent urination?

Only a doctor can clarify the exact cause of polyuria; it is difficult to do this on your own, since several symptoms must be analyzed at once. However, some signs may indicate problems with blood sugar levels. The following symptoms are characteristic of elevated glucose concentrations:

Frequent urination in diabetes mellitus can occur suddenly and quickly intensify. The desire to go to the toilet does not depend on the time of day.
Incessant thirst, the feeling of quenching occurs only temporarily. A similar phenomenon can occur with the feeling of hunger.
Weakness, fatigue.
Enuresis. Urinary incontinence occurs more often in children, but sometimes adults also suffer from it.
Smell of acetone from mouth, urine and body. This effect occurs when glucose levels are high for a long time, when the body tries to stabilize sugar levels without the participation of insulin secreted by the pancreas. As a result of such reactions, a large number of ketone compounds appear in the blood, and they have the specific smell of acetone.

Regardless of whether you have already been diagnosed with diabetes or are experiencing such symptoms for the first time, you should immediately consult a doctor for advice. Taking a blood test, urine test, and, if necessary, an ultrasound of the kidneys and bladder will help determine the exact cause of the pathological process.

How to treat frequent urination in diabetes?

In diabetes, all efforts are aimed at normalizing blood sugar levels. How this will be done depends on the chosen health maintenance regimen. This could be an insulin injection or taking specially selected medications, but in any case the condition needs to be stabilized. In addition, you must adhere to the following rules:

Diet. It is especially important if you have problems with sugar levels to eat healthy foods that do not cause an increase in this indicator.
There is no need to limit yourself to fluids in order to reduce trips to the toilet. This poses serious health consequences. There is a risk of dehydration, since glucose will still remove fluid from the tissues, and the likelihood of intoxication from excess ketone compounds, which provoke the formation of acetone in the blood, also increases.
In consultation with your doctor, limit your intake of diuretics, at least until glucose levels stabilize.

Usually, when sugar is normalized, the manifestation of polyuria decreases; if this does not happen and unpleasant sensations in the form of burning, itching, and pain when urinating are added, then the development of cystitis or other inflammatory diseases is possible. In such cases, recommendations from specialized specialists and restorative therapy, including antibiotics, are needed.

If frequent urination in type 2 diabetes occurs almost constantly, the sugar level is consistently high, maintenance therapy should be adjusted. Prolonged polyuria is dangerous not only for the genitourinary system, but also for the entire body, including psychological disorders.

Source: https://odiabetikah.com/chastoe-mocheispuskanie-pri-diabete.html

Causes

Non-infectious urethritis occurs due to:

irritation of the mucous membrane with small stones in urolithiasis of the kidneys;
trauma to the canal during endoscopic cystoscopy, masturbation, during which some men imprudently introduce various objects into the lumen of the canal;
malignant neoplasms in the canal, which lead to the development of inflammation;
allergic diseases and diabetes, which cause itching, due to which scratching occurs and infectious urethritis begins;
narrowing of the canal due to tumors, prostatitis, benign pancreatic hyperplasia, which leads to stagnation of urine and inflammation;
stagnation of blood in the pelvic veins.

Symptoms

The symptoms of both types of urethritis: non-infectious and non-specific infectious are almost the same and manifest themselves:

itching, burning and other unpleasant sensations;
periodic aching pain under the pubis;
in men – urination disorders;
hematuria - blood in the urine;
“gluing” of the canal opening in the morning due to discharge from the urethra.

Symptoms of specific urethritis are given in Table 1:

How to treat frequent urination in diabetes?

Treatment depends on the cause, but since the main factor in impaired urine output is diabetes mellitus, they begin with compensation for hyperglycemia. For patients with insulin-dependent diabetes, the insulin dose is adjusted and switched to frequent administration of short-acting insulin (before each meal).

If therapy with tablets that lower blood sugar has been prescribed, they are supplemented with long-acting insulin or such patients are completely transferred to insulin therapy. You also need to follow the principles of diet therapy for diabetes, that is, limit carbohydrates by completely avoiding simple sugars, flour products and sweets.

If it is difficult to maintain stable blood glucose levels, it is recommended to switch patients to a low-carbohydrate diet and select only foods with a low glycemic index for the menu. Moreover, even sweeteners are used in low quantities. The second limitation concerns fatty animal products.

Foods with diuretic properties should be completely excluded from the diet:

Treatment of diabetic cystopathy is carried out with anticonvulsants in the presence of pain, anti-inflammatory drugs, antioxidants and vitamins. In this case, the patient is recommended to go to the toilet every four hours, regardless of the urge.

In case of severe disorders, it is recommended to place a catheter, which the patient can do independently (with appropriate training) also at intervals of 4-6 hours.

With the development of diabetic nephropathy, such restrictions are supplemented by a reduction in protein intake to 0.7 g per 1 kg of weight.

So the diet for diabetic nephropathy consists of reducing meat dishes in the diet and switching to a vegetarian style of eating; you can cook dishes from lean fish, steamed or stewed in water once a day. Salt is also reduced or completely eliminated.

The video in this article continues the topic of causes of frequent urination in diabetes.