All body systems are affected by uncontrolled diabetes mellitus as blood sugar levels go high. Involvement of the genitourinary system causes many problems to the sufferer.High levels of blood sugar lead to frequency of urination. In addition to damaging the nervous system, diabetes mellitus leads to several urinary problems. One can begin to pass urine many times in small quantities. Retention of urine can also occur. One can also have urinary incontinence (loss of voluntary control over passing urine) at times. This is a embarrassing situation for any adult. Patients with diabetes are highly prone to develop urinary tract infections because high levels of sugar in the blood provide a rich medium for microbes to grow. Women are more prone to this problem as short length of urethra (tube connecting bladder to outside for voiding urine) facilitates easy entry of germs.Infection of the urinary tract also leads to increased frequency and urgency of urination, i.e., once the urinary bladder is full, there is an intense urgent desire to pass urine immediately. Diabetic women are known to give birth to large size babies. Thus during delivery, they can have injuries to the perineum and urinary bladder, particularly the sphincter controlling the mouth of the bladder. This manifests as retention of urine or incontinence. Repeated and persistent urinary tract infections can lead to chronic infection of the kidneys, which can result in chronic kidney failure.In men, diabetic neuropathy can lead to impotence.Both men and women are susceptible to develop fungal infections of the genital parts and anus due to diabetes, though women are more prone. This manifests as itching over the genital parts which is intermittent and troublesome. Secondary bacterial infection can occur due to scratching. These infections subside temporarily with treatment to relapse again under favourable conditions. For a complete cure, it is imperative that one takes treatment without interruption.These problems can be avoided if a diabetic person keeps sugar well-controlled. Strict adherence to a diabetic diet, regular physical exercise and medication helps in this. Also, avoid alcohol and smoking. Good control of diabetes can delay or retard genito-urinary problems. Drinking water in good quantity flushes the urinary system and helps in preventing settlement of germs, thus preventing development of urinary tract infections.Good perineal hygiene helps to prevent infection of the genitalia. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
