| 摘要: | 糖尿病是世界重要之健康議題，因其持續攀高之盛行率以及具破壞性的後續影響。糖尿病控制不良可能沿生許多慢性合併症，包括：大血管/微血管相關疾病、泌尿道症狀與糖尿病膀胱病變。文獻顯示泌尿道症狀與糖尿病膀胱病變所受到之重視不如糖尿病相關的血管疾病，過往文獻亦顯示糖尿病人常經歷漏尿與夜尿，但漏尿與夜尿於糖尿病婦女之發生狀況與相關因素現存資訊卻非常有限，故進行本研究以瞭解第二型糖尿病婦女之漏尿與夜尿發生狀況，並探討漏尿與夜尿的相關因素。
本研究為一橫斷性之描述性、相關性研究，在某區域醫院以結構式問卷共收集120位糖尿病婦女的相關資料，問卷內容包含：個人特性習慣、睡眠品質、疾病相關特性與泌尿道症狀，另收集糖尿病婦女最近一個月的抽血檢驗數值，並以密西根神經病變篩檢量表檢定周邊神經病變。描述性統計用於呈現糖尿病婦女之漏尿與夜尿發生情況，多變項邏輯斯迴歸用於探討漏尿與夜尿之相關因素。
本研究的120位糖尿病婦女，在過去一個月94位(78.3%)曾經歷漏尿、76位(63.3%)曾經歷夜尿(夜裡起床解尿兩次或兩次以上)。多變項邏輯斯迴歸分析結果顯示：腹圍越大之糖尿病婦女經歷漏尿之風險愈高(OR=1.67, 95%CI=1.089~1.240, p<0.05)。在夜尿部分，有失眠情況(OR=1.44, 95%CI=1.159~ 1.79, p<0.05)、糖化血色素越高(OR=1.67, 95%CI=1.108~ 2.506, p<0.05)以及具周邊神經病變(OR=1.91, 95%CI=1.183~ 3.087, p<0.05)的糖尿病婦女經歷夜尿之風險愈高。
漏尿與夜尿於糖尿病婦女之高盛行率應被投予特殊關注，漏尿與夜尿可能與多個相關因素有關，針對潛在致因提供相關處置/治療可優化婦女之症狀處置，本研究之結果支持健康照護提供者提供針對可調整相關因素而設計之相關介入措施。
Diabetes is a worldwide major health issue due to its increasing prevalence and devastating consequences. Poor diabetes control may lead to many chronic complications including macrovascular/microvascular diseases, lower urinary tract symptoms, and diabetic cystopathy. Previous studies showed that diabetes-related lower urinary tract symptoms and diabetic cystopathy received less attention than diabetes-related macrovascular/microvascular diseases. Previous studies also showed that urinary incontinence and nocturia are common in individuals with diabetes, however, information related to the occurrence rate and correlates of urinary incontinence and nocturia in women with diabetes is limited. This study aimed to examine the prevalence and correlates of urinary incontinence and nocturia in a sample of women with Type II diabetes.
This study was a cross-sectional, descriptive, correlational study. Related information was collected from 120 women with Type II diabetes treated at one metabolism outpatient department in one hospital. A structured questionnaire was used to collect information about women’s individual characteristics and habits, sleep quality, disease-related information, and lower urinary tract symptoms. Information related to women’s blood tests in previous one month was also collected. Peripheral neuropathy was examined using Michigan Neuropathy Screening Instrument. Descriptive statistics were used to present the prevalence of urinary incontinence and nocturia. Multivariate logistic regression was used to identify correlates of urinary incontinence and nocturia.
Of the 120 women with diabetes, 94(78.3%) of them experienced urinary incontinence, and 76(63.3%) of them experienced nocturia (≧2 voids/night) during the past one month. Multivariate logistic regression analysis showed that women who had higher abdominal circumference were more likely to experience urinary incontinence (OR=1.67, 95%CI=1.089~1.240, p<0.05). As to nocturia, logistic regression analysis showed that women who had insomnia (OR=1.44, 95%CI=1.159~ 1.79, p<0.05), who had higher glycated hemoglobin (OR=1.67, 95%CI=1.108~ 2.506, p<0.05), and who had peripheral neuropathy (OR=1.91, 95%CI=1.183~ 3.087, p<0.05) were more likely to experience nocturia.
The high prevalence of urinary incontinence and nocturia in women with diabetes warrants specific attention. The multifactorial nature of urinary incontinence and nocturia supports the delivery of management/treatments targeted at underlying etiologies in order to optimize women’s symptom management. Our study results support that health care providers deliver related interventions aimed at modifiable correlates. |
