Women and Diabetes

Pregnant woman with doctor checking blood sugar level

Diabetes & Women: Its Impact on Your Overall Health

While diabetes affects men and women in almost equal numbers, women with diabetes are more prone to greater health complications than diabetic men, including increased susceptibility to heart disease, the most common complication of diabetes that also happens to be the number one killer of U.S. women.

What’s more, women with diabetes face greater additional health risks over diabetic men, including:

  • lower survival rates and a poorer quality of life after heart attack.
  • higher risk for blindness.
  • higher risk for depression, a condition which affects twice as many women as men. Depression also increases diabetes risk in women, particularly in women during postmenopausal years.

Reproductive-age women also face specific health risks related to diabetes and its potential effects with conception and pregnancy, including:

  • problems becoming pregnant.
  • problems during pregnancy, including possible health problems for both women and their babies.
  • repeated urinary and vaginal infections.

Pregnant women also face risk of developing gestational diabetes while pregnant, which if untreated can cause serious health consequences and even death in mother and baby.

November is American Diabetes Month, and your local Capital Women’s Care team of women’s health professionals want to share important information about prediabetes and the 3 types of diabetes and specific symptoms to be vigilant for; health complications resulting from untreated diabetes and the link diabetes has with other serious health issues, like heart disease, in women; and how you can manage and reduce your personal diabetes risk factors so you enjoy a long quality life.

Prediabetes

Prediabetes indicates having a higher-than-normal blood sugar level. The sugar level isn’t high enough to be considered type 2 diabetes, but without lifestyle changes, adults and children with prediabetes are at high risk of developing type 2 diabetes.

If you’re diagnosed with prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already have begun. However, progressing from prediabetes to type 2 diabetes isn't inevitable. Enacting lifestyle changes like losing weight, eating a healthy diet and increasing physical activity can stave off type 2 diabetes in both children and adults.

Types of Diabetes

There are 3 types of diabetes:

Type 1 Diabetes (also known as juvenile or insulin-dependent diabetes) is a chronic condition where the pancreas makes little or no insulin, a hormone the body uses to allow sugar (glucose) to enter cells to produce energy. Type 1 diabetes may be caused by different factors like genetics or some viruses and usually appears during childhood or adolescence, although it can develop in adults.

Type 1 diabetes risk factors:

  • Family history. Having a parent, brother, or sister with type 1 diabetes.
  • Age. You can get type 1 diabetes at any age, but it usually develops in children, teens or young adults.
  • Whites are more likely to develop type 1 diabetes in the U.S. over African Americans, Hispanics or Latinos.

Type 1 diabetes symptoms:

  • increased thirst
  • frequent urination
  • extreme hunger
  • unintentional weight loss
  • irritability and other mood changes
  • fatigue and weakness
  • and blurred vision.

Type 1 diabetes complications:

  • diabetic ketoacidosis, a life-threatening condition requiring urgent hospital-based treatment.
  • atherosclerosis, where blood vessels become clogged, causing both micro and macrovascular complications. Microvascular complications affect eyes, kidneys and nerves. Macrovascular complication affects heart, brain and blood vessels.
  • kidney failure
  • stroke
  • heart disease
  • blindness
  • or blood vessel blockages due to cholesterol plaques requiring angioplasty/stent placement, amputations or bypass operations.

Extensive research indicates no cure. Effective blood sugar management and monitoring through insulin, blood tests, and diet and lifestyle modifications minimize risk of complications.

Type 2 Diabetes occurs when the body either makes too little insulin or can't use the insulin it makes to use blood sugar for energy. Some type 2 diabetes can be controlled through proper nutrition and regular exercise. Effective management may include diabetes pills and/or insulin plus maintaining a healthy lifestyle including proper nutrition and consistent physical activity.

Type 2 diabetes risk factors:

  • have prediabetes
  • are overweight or obese
  • are 45 years or older
  • have a parent, brother or sister with type 2 diabetes
  • are physically active less than 3 times a week
  • have ever had gestational diabetes or given birth to a baby weighing over 9 pounds.
  • are of African American, Hispanic or Latino, American Indian, or Alaska Native descent. Some having Pacific Island and Asian ancestries are also at higher risk.
  • if you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.

Type 2 diabetes symptoms:

Symptoms for type 2 diabetes usually develop slowly and many times those with type 2 diabetes aren’t even aware they have the condition due to lack of symptoms. Common major symptoms include:

  • frequent urination
  • increased thirst
  • fatigue, tiredness
  • sudden weight loss
  • itching around the genitals
  • slow healing cuts or wounds
  • and blurred vision.

Type 2 diabetes complications:

  • hyperosmolar syndrome, a condition that causes abnormally high level of blood glucose, a medical emergency that can cause death.
  • plus, all noted complications of type 1 diabetes.

Management of type 2 diabetes includes:

Effective management of diabetes helps maintain normal blood sugar levels, delaying or preventing harmful complications.

Gestational Diabetes Mellitus occurs during pregnancy. Every year, 2% to 10% of U.S. pregnancies are affected by gestational diabetes. It can occur in women having type 1 or type 2 diabetes that isn’t being effectively managed or it may occur in women without previous diabetes occurrence due to pregnancy-related hormone fluctuations and weight gain. These changes cause your body’s cells to use insulin less effectively, a condition known as insulin resistance, increasing your body’s insulin needs. All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before becoming pregnant, having an increased immediate need for insulin that makes them more prone to developing gestational diabetes.

Gestational diabetes risk factors:

  • had gestational diabetes during a previous pregnancy.
  • have given birth to a baby who weighed over 9 pounds.
  • are overweight or obese.
  • are more than 25 years old.
  • have a family history of type 2 diabetes.
  • have a hormone disorder called polycystic ovary syndrome (PCOS).
  • are of African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Island descent.

Gestational diabetes usually goes away after you give birth; however, it increases your risk for developing type 2 diabetes. Your baby is more likely to have obesity as a child or teen and develop type 2 diabetes later in life.

Gestational diabetes symptoms:

This condition shows little or no distinguishable symptoms in many women. For some the symptoms may include:

  • increased thirst
  • frequent urination
  • excessive sweating
  • overweightness
  • or fatigue.

If untreated, gestational diabetes can initiate many serious complications, including:

  • heavy birth weight for baby
  • premature delivery
  • Respiratory Distress Syndrome in infants
  • low blood sugar in baby
  • cognitive impairment and developmental delays in baby
  • high blood pressure in baby
  • risk of future diabetes in baby and mother
  • high blood pressure and preeclampsia in mother
  • and death for either baby and/or mother.

Diabetes: Its Link to Serious Health Issues

It’s important to include regular blood screening as part of your personal health plan, even if you don’t experience symptoms or have a family history of diabetes, as uncontrolled diabetes can cause serious health problems. According to the Centers for Disease Control (CDC), 28% of those with diabetes aren’t even aware they have the condition and require medical treatment.

According to a study in Annals of Internal Medicine, diabetes affects women and men differently:

  • Women often receive less aggressive treatment for cardiovascular risk factors and conditions related to diabetes.
  • Some of the complications of diabetes in women are more difficult to diagnose.
  • Women often have different kinds of heart disease than men.
  • Hormones and inflammation act differently in women.

Uncontrolled diabetes can damage arteries and increase likelihood of high blood pressure and formation of blood clots that can lead to heart attack.

Diabetes greatly increases heart disease risk and makes it less likely to survive heart attack for women and men. While the number of men having diabetes who develop heart disease has diminished, it’s important to note the number of women with diabetes who develop heart disease has not gone down in recent years.

Researchers uncovered substantiative links between heart disease, diabetes and obesity, especially if extra body fat is carried around the waist. This link may be stronger for women, especially postmenopausal women, than for men.

Learn more about the link between heart disease and stroke and diabetes in women.

In addition to increased risk of heart disease and stroke, extra glucose within the blood that leads to diabetes can damage nerves and blood vessels. Nerve damage from diabetes can lead to pain or permanent loss of feeling in hands, feet and other parts of the body.

Damaged blood vessels due to diabetes can also lead to

Additionally, all women planning to conceive need to be vigilant about gestational diabetes, a form of diabetes that only occurs during pregnancy. Gestational diabetes can arise due to insulin resistance, especially during the latter stage of pregnancy. Maintaining a personal pregnancy health plan that includes making all recommended visits to your Capital Women’s Health practitioner to monitor the health of you and your unborn baby is the best way to monitor for gestational diabetes and implement treatment if necessary.

Testing for Diabetes

Three tests can determine prediabetes and diabetes:

  • HbA1C (A1C or glycosylated hemoglobin test.) The A1C test measures average blood glucose control for the past 2-3 months. Blood sugar is measured by the amount of glycosylated hemoglobin (A1C) in blood. This test is more convenient as fasting isn’t required.

    An A1C of 5.7% to 6.4% indicates prediabetes, and high risk for developing diabetes. Diabetes is diagnosed when the A1C is 6.5% or higher.

  • Fasting Plasma Glucose Test. A fasting plasma glucose test requires fasting (nothing to eat or drink except water) for 8 hours before the test. Blood is drawn for analysis. The plasma is combined with other substances to determine glucose amount within the plasma. Blood glucose is measure in milligrams per deciliter (mg/dL).

    A blood glucose range of 100-125 mg/dL indicates prediabetes (also known as impaired fasting glucose.) This range indicates increased risk of developing type 2 diabetes, heart disease and stroke.

  • Oral Glucose Tolerance Test. This test measures how well the body handles a standard amount of glucose. Blood is drawn before and two hours after you drink a large, premeasured beverage containing glucose. Comparison of the before-and-after glucose levels contained in plasma indicates how well the body processed the sugar. These levels are measured in mg/dL.

    A blood glucose range of 140 to 199 mg/dL indicates prediabetes, signifying increased risk of developing type 2 diabetes, heart disease and stroke. A blood glucose range of 200 or greater mg/dL indicates type 2 diabetes and a greater risk of developing heart disease and stroke.

    If you're a pregnant woman at average risk of gestational diabetes mellitus, you'll likely have a screening test during your second trimester, between 24 and 28 weeks of pregnancy. If you're determined to be high risk, your health care provider may test for diabetes early in pregnancy, likely at your first prenatal visit.

Reducing Type 2 Diabetes Risk

Many studies, including the large Diabetes Prevention Program study, have proven you can prevent diabetes by losing weight. Weight loss through healthy eating and an increase in daily physical activity improves the way your body manages and utilizes insulin and glucose.

  • Lose weight. Obesity is a leading risk factor for diabetes. Calculate your BMI to see whether you’re at a healthy weight. If you’re overweight or obese, start making small changes to your eating habits and get more physical activity.

    Even a small amount of weight loss (7%, or about 14 pounds for a 200-pound woman) can delay or even prevent type 2 diabetes.

  • Eat healthy. Choose vegetables, whole grains (such as whole wheat or rye bread, whole grain cereal or brown rice), beans and fruit. Read food labels to help you choose foods low in saturated fats, trans fats and sodium. Limit processed and sugary foods and drinks.

  • Get active. Aim for 30 minutes of physical activity most days of the week and limit the amount of time you are sedentary.

    Learn more about how to eat healthier and get more physical activity to reduce your diabetes risk.

  • Have your blood glucose levels checked regularly per your doctor’s recommendations. If you are planning pregnancy, talk with your Capital Women’s Care practitioner about devising a personalized preconception health plan so you are at peak health now to reduce health risks to you and your baby during upcoming pregnancy and delivery. Also maintain regular pregnancy check ups and tests, including for glucose tolerance, to monitor risk of developing gestational diabetes in the latter part of pregnancy.

Your local Capital Women’s Care team of dedicated women’s health experts is here to address your concerns and answer your questions regarding diabetes and any women’s health issue. Our focus is to provide you with unparalleled, clinical excellence and comprehensive healthcare so you enjoy a long quality life.

Sources:

https://www.fda.gov/consumers/womens-health-topics/women-and-diabetes
https://www.cdc.gov/pregnancy/diabetes.html
https://www.cdc.gov/pregnancy/diabetes-gestational.html
https://www.cdc.gov/pregnancy/diabetes-types.html
https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-...
https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html
https://www.womenshealth.gov/a-z-topics/diabetes
https://www.womenshealth.gov/heart-disease-and-stroke
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861464/
https://www.healthline.com/health/diabetes/symptoms-in-women
https://www.acog.org/womens-health/faqs/diabetes-and-women

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