5 Facts About Overactive Bladder and Insulin Resistance

But what is 'insulin resistance'? Insulin resistance is estimated to affect around 25% of the population, and there's emerging evidence that there is a connection between insulin resistance and overactive bladder.

Insulin resistance is when cells in the body do not respond properly to insulin, a hormone produced by the pancreas that helps regulate blood sugar levels. When this happens, your body needs more insulin to keep blood sugar levels in check. Over time, the pancreas can't keep up, leading to elevated blood sugar levels.

Estrogen, beyond its reproductive roles, plays a pivotal role in regulating glucose metabolism and insulin sensitivity. As estrogen levels drop, the body can become less responsive to insulin, a condition known as insulin resistance. This reduced sensitivity means that the body needs more insulin to achieve the same glucose-regulating effects. Consequently, the pancreas might overproduce insulin, leading to higher circulating insulin levels. This hormonal shift, intertwined with other factors like age-related changes in muscle mass and metabolism, places perimenopausal women at an increased risk for insulin resistance, which can pave the way for conditions like type 2 diabetes if not addressed.

It's important to note that while insulin resistance is a precursor to type 2 diabetes, it isn’t the same as diabetes. In diabetes, the body either doesn't produce enough insulin or can't use it effectively, leading to high blood sugar. Insulin resistance can be diagnosed through blood tests that measure blood sugar and insulin levels.

Wondering if this might be causing your overactive bladder? Here's five facts to consider:

1. You might not know if you are insulin resistant

Common signs of insulin resistance include fatigue, hunger, difficulty concentrating, weight gain, and dark patches of skin (acanthosis nigricans). However, these symptoms can be subtle or overlap with other conditions like perimenopause, so it can be hard to know whether you are insulin resistant. It's essential to see your GP and ask for blood tests for an accurate diagnosis if you suspect that your symptoms are pointing to insulin resistance.

2. There is a developing link between Insulin Resistance and OAB

Insulin resistance can lead to increased production of urine by the kidneys, resulting in an overactive bladder. Additionally, high blood sugar levels can irritate the bladder lining, causing urgency and frequent urination.

While it's worth mentioning that research is continuing, recent studies suggest a link between insulin resistance and overactive bladder. In particular, the insulin level was higher in females with OAB and lower in the 'control' group. We can conclude from these studies that there's growing consensus that women with insulin resistance have a higher risk of developing OAB.

3. Estrogen plays a part too

Estrogen, beyond its reproductive roles, plays a important role in regulating glucose metabolism and insulin sensitivity. As estrogen levels drop during perimenopause, the body can become less responsive to insulin and you may find that you are insulin resistant as a result.

This reduced sensitivity means that the body needs more insulin to achieve the same glucose-regulating effects. Consequently, the pancreas might overproduce insulin, leading to higher circulating insulin levels. This hormonal shift, intertwined with other factors like age-related changes in muscle mass and metabolism, places perimenopausal women at an increased risk for insulin resistance, and of course increase the risk of OAB.

Insulin resistance, if left unmanaged, can pave way for conditions like type 2 diabetes if it isn't addressed.

4. You don't need to be overweight to be insulin resistant.

We generally think of insulin resistance as being linked to obesity, but it's crucial to understand that slim individuals are not immune to this condition. All body types can be susceptible to insulin resistance, as factors that contribute to its development can be due to lack of movement and regular exercise, poor dietary choices, and even chronic stress. For women over 40, there's an added layer of complexity due to the natural decline of estrogen, and even slender women can find themselves grappling with insulin resistance. This highlights the importance of considering factors beyond body weight, such as lifestyle and hormonal balance, when assessing the risk and presence of insulin resistance in middle-aged women.

5. It might be why you are dashing for the loo in the night

If you are up and down all night with a niggling bladder, one of the consequences of insulin resistance can be nocturia – the need to urinate frequently during the night.

When someone has insulin resistance, their blood sugar can become too high. The body then tries to get rid of this extra sugar through urine. So, what happens is the kidneys start making more urine, and that can fill up the bladder quickly, making someone feel the need to go to the bathroom more often, even at night. On top of that, the high sugar can make the bladder feel irritated, sort of like how you'd feel if you had a rash—itchy and uncomfortable. This discomfort makes you feel like you need to go to the bathroom urgently, even if your bladder isn't entirely full. So, if you're waking up a lot to pee at night and you don't know why, insulin resistance might be a reason.

How can I manage insulin resistance?

The good news is that insulin resistance is absolutely manageable, and dealing with it early can prevent progression to type 2 diabetes. In the UK, the NHS recommends lifestyle changes as the primary treatment. This includes adopting a balanced diet, regular physical activity, and maintaining a healthy weight. If you need further intervention to manage the progression to Type 2, your doctor will advise of the best course of action.

You can also look to supplementation for support with insulin resistance. Natural dietary supplements like cinnamon, berberine, and chromium have shown potential in improving insulin sensitivity. For your bladder, a supplement containing pumpkin seed - like Jude's Bladder Strength supplement - can help to soothe, and reduce the symptoms of OAB by up to 60% during the day, and 70% for night time wees.

Do consult your GP if you are experiencing any symptoms of insulin resistance or overactive bladder before starting any supplements or making significant changes to your routine.