Incontinence: Ask the Expert

Question: I have type 2 diabetes. I can’t get enough sleep because I have to go to the bathroom every half hour. What should I do?

Several things may be contributing to your symptoms. People need to go to the bathroom during the night for three reasons: 1) your body is making more urine; 2) your bladder capacity is reduced; or 3) something else is causing you to wake up.

There are several reasons why persons with diabetes may make more urine at night. If your blood sugars are not well controlled and run high overnight, your body may respond by making more urine in order to excrete the sugar, causing you to go the bathroom more frequently.

Some drugs used to treat diabetes (rosiglitazone and posiglitazone) can cause swelling of the ankles and lower legs. When you go to bed and elevate your legs, the extra fluid in your feet is reabsorbed, causing your kidneys to excrete more urine.

Persons with diabetes often have high blood pressure, and some antihypertensive medications can cause foot swelling as well (the calcium channel blockers amlodipine and nifedipine).

Check with your health care provider whether any of these factors may be an issue for you, and whether you might have other medical conditions that can cause excess urine production at night (congestive heart failure or sleep apnea).

Persons with diabetes may have reduced bladder capacity either because of bladder spasms and/or failure to empty their bladder completely. However, both of these conditions should cause frequent voiding during the day as well as night. If your symptoms only occur at night, then the most likely cause is either that you are making more urine at night, or something else is awakening you.