This content was originally produced for audio. Certain elements, such as tone, sound effects, and music, may not fully capture the intended experience in textual representation. Therefore, the following transcription may have been modified for clarity. We recognize not everyone can access the audio podcast. However, for those who can, we encourage subscribing and listening to the original content for a more engaging and immersive experience.
All thoughts and opinions expressed by hosts and guests are their own and do not necessarily reflect the views held by the institutions with which they are affiliated.
The Link Between Diabetes and Bladder Health
Dr. Jones: Diabetes and the bladder, you never think of these two things going hand in hand. You think of a cupcake and diabetes, not the bladder and diabetes, but today we're talking about diabetes and the bladder. This is Dr. Kirtly Jones, and this is The Scope.
Here in The Scope studio, we have Dr. Sara Lenherr, who is a urologist by training but subspecialty-trained in neurology. Today we're talking about diabetes because diabetes is a complex disease. It affects every part of the body, and the bladder is the final common pathway of both nerves and sugar and trouble. Welcome to The Scope, Sara.
Dr. Lenherr: Thank you for having me.
Dr. Jones: I think in my own practice, sometimes I diagnose diabetes because of women's urinary frequency. So can you tell us a little bit about how the first signs of diabetes might affect the bladder?
Dr. Lenherr: Sometimes women with poorly controlled diabetes end up having a bladder that spasms too frequently, and that can be very bothersome. It makes them feel like they have to go more frequently and urgently.
Frequent Urination May Be an Early Sign of Diabetes
Dr. Jones: Also, sometimes people who don't know they have diabetes yet, their sugars are high, the kidneys are trying to dilute that sugar, and they just pee a lot.
Dr. Lenherr: Yes, frequently these patients make too much urine because their kidney function is affected, and so they just make more urine than the bladder can handle, and it makes them feel like they need to go more frequently, and they do.
Dr. Jones: So, peeing a lot in large volumes, for me, I remember that from medical school, you'd better make sure they don't have diabetes.
Dr. Lenherr: Exactly.
Long-Term Diabetes Can Damage the Bladder
Dr. Jones: Over the long term, though, diabetes affects your nerves in your feet and affects other parts of your brain, but talk about the bladder in long-term diabetes.
Dr. Lenherr: Diabetes in patients who have had it for a long time can affect the fingers and toes, and all that sensation also affects all of the nerves that go to the bladder, and so the bladder doesn't necessarily contract at the right time. Either it's overactive, or it's underactive. It doesn't contract well enough, and therefore it doesn't squeeze when you want it to, and you don't empty your bladder completely.
How Doctors Diagnose Diabetic Bladder Problems
Dr. Jones: So, in terms of diabetes, we certainly want people to be in good control, because that might help early on with a lot of their bladder symptoms, meaning if their sugars are in good shape, their bladder will probably be in good shape. But for people who have been diabetic for a long time and weren't in such great control, and now they have more permanent damage, how do you make that diagnosis?
Dr. Lenherr: Usually, we check and see whether or not the bladder empties completely. Once you go, we can then check and see if you have any residual left over in your bladder, and then we can also check bladder function tests where we measure the pressures inside the bladder and see how your bladder behaves when filling and then trying to empty your bladder.
Dr. Jones: Is that very comfortable? Reassure me that that's not going to be a painful test.
Dr. Lenherr: It's a very simple test that's done in the office. We put a very small catheter that's smaller than the mouse cord that goes to your computer, and we place that inside your bladder, and we also place a very similar small one inside the rectum. This helps us look at how the bladder behaves with filling and emptying to measure those pressures and see whether or not your bladder nerves are working properly.
Treatment Options for Diabetic Bladder Dysfunction
Dr. Jones: Okay, maybe I would have this test. Okay, I'll have this test. So, I had this test, and my bladder isn't contracting very well. What are you going to do? What can you do to help me with this?
Dr. Lenherr: Depending on how much your bladder is injured, sometimes we have to have patients actually just pass a small catheter every four hours while they're awake to empty their bladder as opposed to trying to pee it out. But if you have a little bit of bladder function, then sometimes we can actually give you a bladder pacemaker that helps your bladder contract in a much more efficient manner, and therefore you're able to empty without having to use that catheter.
Managing Bladder Problems in Older Adults with Diabetes
Dr. Jones: How about as people get older? I think of the elderly patient with what we call comorbidity, so they're older, they have diabetes, they have heart disease because it's affected their heart, maybe they had a stroke. Urinary incontinence is the number one reason to be admitted to a nursing home. So what do we do for older people? Can they do their own catheterizations, or is this something a family can help them with?
Dr. Lenherr: The complex patient with incontinence is definitely some of the more challenging cases that we have, and it's a balance between figuring out what the goals of care are. Some patients are very happy to have family help them catheterize if they need that to be done. Sometimes patients would rather not have their family members be going down there and helping them pass a catheter, and depending on how the bladder works, it can be a very good option to leave a chronic catheter in place.
Usually, we try to place that in a suprapubic location, so right above the pubic bone, below the belly button, and that helps drain the bladder and improves quality of life in a lot of patients. But these are really specialized conversations that we have with both the patients and their families to determine who is going to help the patient and who is going to be able to help keep the patient safe and happy.
Some of the more rewarding conversations are having these discussions where you have patients understand these are my choices, and this is what my goals of care are, and it's not always a quick fix, and it's not always the most complicated solution. Sometimes it just needs to be something simple that everyone agrees is what I want to have my life be like, and I'm there to offer those solutions for them.
updated: July 7, 2026
originally published: December 23, 2015
More Answers and Resources for Your Women's Health Concerns
Learn More From Our Specialists
Do You Urinate a Lot? It Might Be Diabetes
Frequent urination is often associated with diabetes, but many people do not realize the disease can also damage the nerves that control the bladder over time. Learn how diabetes affects bladder function, the tests used to diagnose diabetic bladder dysfunction, and the treatment options available.
Frequent Bathroom Trips? Recognize the Signs of Overactive Bladder
Overactive bladder affects millions of adults, but most people keep their symptoms quiet — even when urgency and frequency start to control their day. Learn about the causes, contributors, and solutions that help adults manage overactive bladder with dignity and clarity.
Overactive Bladder in Women: Symptoms, Treatments, and How to Take Back Control
If frequent bathroom trips disrupt your life, you are not alone. Learn about the importance of lifestyle changes and when it is time to seek professional help.
