Epidemiological Insights into Lower Urinary Tract Symptoms among Adults with and without Diabetes in South India

Background: Lower urinary tract symptoms (LUTS) are highly prevalent and impact quality of life through sleep disruption, reduced productivity, and psychological distress. Type 2 diabetes mellitus (T2DM) has been implicated in exacerbating LUTS through mechanisms such as autonomic neuropathy and poor glycemic control. However, data from gender-inclusive, hospital-based cohorts in India are limited. Methods: This hospital-based, cross-sectional pilot study was conducted at a tertiary care urology center in Andhra Pradesh, India. Eighty adults with at least one LUTS were enrolled, including 40 with T2DM and 40 non-diabetic controls. Symptom burden was assessed using the International Prostate Symptom Score (IPSS), Urogenital Distress Inventory (UDI-6), and International Consultation on Incontinence Questionnaire (ICIQ-UI SF). Fasting blood glucose (FBG) levels were recorded, and management strategies documented. Statistical analyses included independent t-tests, chi-square tests, and multivariable regression. Results: Severe LUTS (IPSS ≥20) was more common in diabetics (35% vs. 20%), alongside higher frequencies of nocturia (30% vs. 25%) and urinary incontinence (25% vs. 20%). Although group differences were not statistically significant, FBG correlated positively with IPSS and UDI-6 scores, suggesting a link between glycemic status and symptom severity. Multivariable regression identified age as the strongest independent predictor of LUTS severity (p=0.008). α-blockers were the most frequently prescribed treatment in both groups. The prevalence of severe LUTS (IPSS ≥20) was higher in diabetics (35%) compared to non-diabetics (20%). Nocturia (≥2/night) was reported by 30% of diabetics and 25% of controls, while urinary incontinence was observed in 25% and 20%. Conclusion: This pilot study suggests that age is the predominant determinant of LUTS burden, while diabetes contributes indirectly through glycemic control. Larger multicentric studies are warranted to clarify metabolic and sex-specific influences, supporting integrated screening of LUTS in both geriatric and diabetic care pathways.