Screening for Bowel and Bladder Dysfunction in Children with Diabetes

Purpose: Bowel and bladder dysfunction (BBD) has been reported in adults with diabetes mellitus (DM). Studies of children with DM are limited. The goal of this investigation was to evaluate the incidence of BBD in children with DM. Materials and Methods: We prospectively studied 72 children seen at our pediatric endocrinology clinic and compared them with 71 patients seen in our pediatric urology clinic without complaints of BBD. We used the slightly modified validated Swedish Bowel and Bladder Questionnaire (BBQ) and collected demographic data. Results: 67 patients had T1DM, and 5 patients had T2DM; the median duration was 31.5 months. Demographics were comparable, but the control group had a higher number of boys (66 [93%] vs 34 [47%]; P = <.001). The number of participants with attention-deficit/hyperactivity disorder was similar (control 3 [4%], DM group 8 [11%]; P = .13). There were higher total BBQ scores for those with DM (median difference 1, 95% confidence interval, 0-1, P = .03) along with an increased number of children with > 7 voids per day (control 2 [3%], DM 16 [23%]; P = .04). Conclusions: Children diagnosed with DM for a median of 31.5 months demonstrate mostly normal bladder function with a slight, clinically insignificant increase in BBQ. However, 23% void more than 7× per day. Our data suggest that the BBQ can be used by urologists or nonurologists as a good screening tool for children with DM. Our results suggest that there is potentially a high-risk group of children (those voiding >7×/d). Further investigation and follow-up of this group will determine whether they are at risk for ongoing voiding dysfunction.