From the Guidelines

Relationship between Increased Urinary Frequency and Hypoglycemia

The relationship between increased urinary frequency and hypoglycemia can be understood through various mechanisms.

Increased urinary frequency can be a side effect of certain medications used to manage hypoglycemia, such as SGLT2 inhibitors, which can cause increased glucose excretion in the urine, leading to increased urinary frequency 1.
Hypoglycemia can trigger a stress response, leading to the release of hormones like adrenaline, which can cause vasoconstriction of renal blood vessels, potentially decreasing renal blood flow and glomerular filtration rate (GFR).
The counter-regulatory response to hypoglycemia involves the release of hormones like glucagon, which can increase GFR and renal blood flow, potentially leading to increased urine production and frequency.

Certain populations, such as those with diabetes, may be more prone to hypoglycemia and increased urinary frequency due to medication side effects or disease-related complications.
The use of certain medications, such as sulfonylureas, can increase the risk of hypoglycemia, which may contribute to increased urinary frequency 1.
Patients with inconsistent eating patterns or those who are frail may be more susceptible to hypoglycemia and increased urinary frequency due to medication side effects or disease-related complications 1.

The relationship between increased urinary frequency and hypoglycemia is complex and involves multiple mechanisms.

Increased urinary frequency can be a side effect of certain medications used to manage hypoglycemia, such as SGLT2 inhibitors, which can cause increased glucose excretion in the urine, leading to increased urinary frequency.
Hypoglycemia can trigger a stress response, leading to the release of hormones like adrenaline, which can cause vasoconstriction of renal blood vessels, potentially decreasing renal blood flow and glomerular filtration rate (GFR).
The counter-regulatory response to hypoglycemia involves the release of hormones like glucagon, which can increase GFR and renal blood flow, potentially leading to increased urine production and frequency.
Studies have shown that patients with diabetes are predisposed to develop lower urinary tract dysfunction, including increased urinary frequency, due to poor glycemic control 2.
The frequency and duration of hypoglycemia can increase as the risk factor values, such as average glucose and coefficient of variation, increase 3.
Hypoglycemia can occur before insulin therapy in patients with type 1A diabetes, and these patients may be at risk of developing urinary retention due to diabetic neuropathy 4.
The definition of hypoglycemia can affect the reported frequency of hypoglycemia, and the glucose cut-off point defining hypoglycemia should be set at a lower level than the threshold of 3.9 mmol/l proposed by the American Diabetes Association 5.

Certain populations, such as those with diabetes, may be more prone to hypoglycemia and increased urinary frequency due to medication side effects or disease-related complications.
Patients with inconsistent eating patterns or those who are frail may be more susceptible to hypoglycemia and increased urinary frequency due to medication side effects or disease-related complications.
The use of certain medications, such as sulfonylureas, can increase the risk of hypoglycemia, which may contribute to increased urinary frequency.
Diabetic neuropathy can significantly predict lower urinary tract symptoms in women with type 2 diabetes, and poor glycemic control can increase the risk of developing urinary retention 2.
Clinicians should be aware of the association between urinary retention and glycemic control, and educate patients about this relationship 2.