Beyond Glycemic Control: Exploring the Overlooked Interplay between Bladder Dysfunction, Sleep Quality, and Life Quality in Type 2 Diabetes Mellitus

Introduction: Type 2 diabetes mellitus (T2DM) is often comorbid and, along with non-glycemic complications such as bladder dysfunction and sleep disturbances, significantly reduces the health-related quality of life (HRQoL). In Pakistan, these associations have remained unexplored. The present study sought to investigate whether diabetic bladder dysfunction (DBD) was associated with the sleep quality and HRQoL in adults with T2DM. Methods: This study employed a cross-sectional design among 300 T2DM patients selected from outpatient departments in Islamabad and Rawalpindi using convenience sampling. The instruments were validated using the International Consultation on Incontinence Questionnaire-Short Form, Pittsburgh Sleep Quality Index, and Short Form-36 Health Survey. Pearson correlations, t-tests, analysis of variance, and multiple linear regression were used to analyze the data. Results: Poor sleep quality was positively associated with urinary incontinence (r = 0.472, p < 0.001) and negatively correlated with HRQoL (r = -0.487 to -0.561, p < 0.001). Urinary incontinence was also negatively associated with HRQoL (r = -0.446 to -0.528, p < 0.001). Regression analyses showed that poor sleep (β = -0.289 to -0.312), urinary incontinence (β = -0.218 to -0.228), age (β = -0.164 to -0.176), and female gender (β = -0.152 to -0.162) were independently associated with lower HRQoL (p < 0.01). Conclusions: Poor sleep and bladder dysfunction are independent and collective contributors to poor quality of life in T2DM. The inclusion of these factors, along with glycemic control, could lead to more comprehensive diabetes care.