Diabetes mellitus, or diabetes, is a disease affecting the regulation of blood glucose (sugar) levels.
An organ called the pancreas creates the hormone insulin, which helps keep blood sugar levels in a healthy range.
With diabetes, the pancreas either doesn’t make enough insulin, or the body doesn’t respond to it well. Without proper insulin function, blood sugar levels rise and can lead to health problems if left untreated.
Diabetes is becoming more prevalent worldwide. As of 2015, 30.3 million people in the United States, or about 9.4 percent of the population, had diabetes.
Unfortunately, more than 1 in 4 people with diabetes don’t know they have it. Having undiagnosed diabetes increases the risk of complications from lack of prompt treatment.
Many people also have prediabetes, a condition where blood sugars are slightly elevated but not high enough to be considered diabetes.
Having prediabetes is a major risk factor for eventually developing type 2 diabetes. The U.S. Centers for Disease Control (CDC) estimates that up to 30% of people with prediabetes will develop type 2 diabetes within five years of their prediabetes diagnosis.
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Diabetes in women
Diabetes affects both men and women, and can even affect children. Men are typically diagnosed with prediabetes more often than women, but women are still susceptible. It’s estimated that about 15 million women in the United States have diabetes.
Over 199 million women live with diabetes, with the projection of that number increasing to 313 million by 2040. Diabetes is the ninth leading direct cause of death in women worldwide, causing over 2 million deaths each year.
People over the age of 45 are most likely to be diagnosed with diabetes, but it’s also being seen more in teenagers and younger adults. Most people with diabetes have type 2 diabetes, which is linked to both genetic and lifestyle factors.
Diabetes increases the risk of heart disease. On its own, heart disease is the leading cause of death in women, which makes properly managing diabetes even more crucial for health and longevity. Women with diabetes are also four times more likely to have a stroke than women without diabetes.
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Signs and symptoms of diabetes in women
Having high blood sugar usually doesn’t come without symptoms if it’s acute (short-term). When blood sugar levels are chronically high, such as in the case of diabetes, symptoms can arise. Some common symptoms of diabetes include:
- Urinating (peeing) more often than usual
- Increased thirst
- Unintentional weight loss
- Increased hunger
- Blurry vision
- Numb or tingling hands or feet
- Dry skin
- Slowly-healing sores or wounds
- Increased rate of infections
Pregnancy and diabetes
Women with diabetes (type 1, type 2, or gestational) are at increased risk of complications during pregnancy if blood sugar isn’t well-managed. Many women with diabetes have healthy pregnancies and babies, but more caution is taken when it comes to their treatment plan to ensure both mother and baby stay healthy.
Having high blood sugar during pregnancy can increase the risk of preterm birth and birth defects. Babies born to mothers with diabetes may also be large for their gestational age or have low blood sugar problems after they are born.
Pregnant women with diabetes are also at higher risk of gaining too much weight during their pregnancy and developing a dangerous condition called preeclampsia.
Even if a woman’s blood sugar levels were well-controlled prior to getting pregnant, pregnancy hormones could make blood sugar more erratic and difficult to control. Close follow-up with a healthcare provider trained in pregnancy and diabetes is recommended to minimize the risk of complications.
Type 1 diabetes
Type 1 diabetes is an autoimmune disease. The body mistakenly views the pancreas’ beta cells as invaders, and it works to destroy them. People with type 1 diabetes have little to no beta-cell function left and must inject insulin in order to live a healthy life.
Type 1 diabetes is the rarest of the types of diabetes, affecting about 2-5% of the world’s population and about 1 in 300 American adults before the age of 18. Type 1 usually occurs before age 18, which is why it’s also referred to as juvenile diabetes.
Unlike type 2 diabetes, type 1 diabetes isn’t associated with lifestyle factors such as weight, ethnicity, physical activity level, etc. In fact, many people with type 1 diabetes can appear thin and be at a normal weight or be underweight. This occurs due to the complete lack of insulin, which is needed to feed the body’s cells.
The risk factors for type 1 diabetes aren’t as well-understood as the other types of diabetes because of its nature as an autoimmune disease. Risk factors for developing type 1 diabetes include:
- Family history: people with a parent or sibling with type 1 diabetes are more likely to develop it than people without a family history.
- Genetics: certain genes tend to indicate an increased risk of type 1 diabetes.
- Geography: incidence of type 1 diabetes tends to increase as the distance from the equator increases.
- Age: the first peak of diagnosis tends to occur between ages 4-7, and again between ages 10-14.
Type 2 diabetes
Type 2 diabetes is much different than type 1. It can occur in adolescence but is more common in older adults. Unlike type 1 diabetes, it isn’t an autoimmune disease. Type 2 diabetes occurs when the pancreas stops producing enough insulin, or the body doesn’t respond to insulin the way it should. When the body doesn’t use insulin effectively, it’s called insulin resistance.
People with type 2 diabetes may not always need to inject insulin to manage it. Other diabetes medications, many in pill form, can be used to treat type 2 diabetes. Some people with type 2 diabetes can even manage it through lifestyle alone, without the need for medication.
The risk factors for type 2 diabetes are much more well-known than for type 1:
- Weight: women who are considered overweight or obese according to their body mass index (BMI).
- Age: women 45 and older are at increased risk.
- Family history of diabetes
- Race/ethnicity: diabetes tends to affect certain races more than others. At-risk races include African American, Alaska Native, Native American, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander.
- High blood pressure: blood pressure higher than 120/80 increases risk.
- Altered lipid levels: low levels of HDL “good” cholesterol and high levels of LDL “bad” cholesterol are risk factors, as well as high triglycerides (blood fat).
- Pregnancy history: women with a history of gestational diabetes (GDM) or gave birth to a baby 9 pounds or heavier are at increased risk.
- Physical activity: women who aren’t regularly active or have a sedentary lifestyle are at increased risk.
- Smoking status: Smokers are 30-40% more likely to develop type 2 diabetes than nonsmokers.
- Health history: women with a history of heart attack or stroke have a higher likelihood of developing type 2 diabetes.
- PCOS: Polycystic Ovarian Syndrome (PCOS) in women is a risk factor, as it usually is associated with insulin resistance.
- Acanthosis nigricans: dark, velvety patches of skin are a sign of insulin resistance and are a risk factor for developing diabetes. These patches of skin usually occur around the neck or armpits.
Gestational diabetes (GDM) affects women during pregnancy. It occurs in women without a previous history of diabetes. The drastic shift in hormones during pregnancy can trigger insulin resistance, resulting in higher blood sugars. It typically goes away after pregnancy.
Pregnant women without a previous history of GDM are screened for this condition between 24 and 28 weeks of pregnancy. Those with a history of GDM are screened earlier. Having GDM is a risk factor for developing type 2 diabetes later in life, so women should continue to have their blood sugar checked periodically after pregnancy.
Screening for GDM involves a glucose tolerance test. A drink with sugar is given to the pregnant woman, and her blood sugar is tested one hour after. If it’s high, she’ll do a 3-hour glucose tolerance test, with her blood sugars being measured once every hour for three hours after drinking a sugary drink. GDM will be diagnosed based on the results of the glucose tolerance test.
Risk factors for developing GDM include:
- Being at a higher weight when becoming pregnant.
- Being African-American, Asian, Hispanic, or Native American
- Having a history of prediabetes or GDM
- Having high blood pressure or other medical problems
- Having given birth to a large baby weighing 9 pounds or more
- Having given birth to a stillborn baby or one with birth defects
- Being over the age of 25
Complications of diabetes
High blood sugar damages blood vessels and body organs over time, which can lead to diabetes complications.
Serious complications can be prevented through good self-care and regular medical follow-up, such as having routine blood work done and visiting with a healthcare provider.
Some of the ways diabetes can cause complications to include:
- Heart health: Having diabetes can cause hardening of the arteries called atherosclerosis, which is a risk factor for developing cardiovascular disease (heart disease). If an artery becomes too narrow, it can become blocked, which results in a heart attack (myocardial infarction) or stroke, depending on where the blockage occurs. Diabetes is also linked with dyslipidemia or abnormal cholesterol levels. Having high LDL (bad) cholesterol and low levels of HDL (good) cholesterol increases the risk of heart disease.
- Urinary and sexual issues: Women with diabetes are at higher risk of developing urinary tract infections due to increased sugar in the urine, which feeds bacteria and yeast. Women with diabetes may also be at increased risk of vaginal dryness from damage to the nerves that lubricate the vagina. This can lead to painful intercourse and sexual dysfunction. Some studies have even found that women with diabetes are more likely to experience sex drive issues, especially those suffering from depression.
- Neuropathy and retinopathy: High blood sugar can cause nerve damage, known as neuropathy. Many people experience this in the form of peripheral neuropathy. Peripheral neuropathy causes pain as well as numbness and tingling of the extremities. Diabetes can also damage the blood vessels in the eyes, which leads to retinopathy. Retinopathy can potentially lead to loss of vision.
- Wound healing: High blood sugar impairs the body’s ability to heal itself. When wounds don’t heal quickly, there is a higher chance of infection. The chances of wound complications are even higher if the person also has neuropathy because they can’t feel the wound, and it may go untreated for a long time.
If limbs are severely damaged from a poorly healing wound, it may need to be amputated. In fact, diabetes is thought to be the leading cause of leg amputations worldwide.
Treatments for diabetes
Fortunately, there are many different treatment options for women with diabetes. Treatment plans aren’t a one-size-fits-all but are instead personalized to meet the unique needs of each person.
Some women can manage their diabetes without medications, and others need medication. Taking medication doesn’t mean someone has failed at controlling their blood sugars; it often means that the pancreas is poorly functioning to respond well to lifestyle changes alone.
There are several approaches to manage diabetes, including:
Some of the more popular medications used to treat diabetes include:
- Metformin: Helps to reduce the amount of sugar released by the liver and improves insulin sensitivity.
- Sulfonylureas: Stimulate the pancreas to secrete more insulin
- GLP1 receptor agonists: Promote insulin production, decrease glucose release from the liver, and slows stomach emptying to increase satiety
- DPP-4 inhibitors: Promote insulin production, decrease glucagon (a hormone that increases blood sugar) production, and delays gastric emptying.
- Insulin is available in different types: long-acting, short-acting, rapid-acting, intermediate-acting, and mixed. They differ in how quickly they take to work, how long until they are working the most to lower blood sugar and how long they last to provide blood sugar control. People with type 1 diabetes are insulin-dependent and usually take at least two types of insulins on a daily basis.
Making sustainable lifestyle changes can help promote healthy blood sugar levels.
Cut back on sugar. While eating sugar doesn’t cause diabetes, a higher intake of sugar has been associated with an increased risk of diabetes, along with many other factors. Added sugars tend to be especially detrimental to health since they don’t provide any nutritional value and cause large blood sugar fluctuations.
Added sugar is hidden in many common foods, which can make it hard to avoid for those who don’t know how to identify added sugar. Foods that are marketed as healthy can actually be very high in sugar, such as yogurts, cereal, and nutrition bars. Added sugar is also hidden in less-obvious foods like pasta sauce, salad dressings, and condiments.
The American Heart Association recommends that women consume no more than 6 teaspoons of added sugar per day (24 grams) and men consume no more than 9 teaspoons of added sugar per day (36 grams).
Exercise. Being physically active is a very important way to help control diabetes. 150 minutes per week of moderate physical activity, such as brisk walking, is recommended. Strength training is also beneficial for improving blood sugar, and it can also improve bone health. This is especially important since women are at a higher risk of bone loss at a younger age compared to men.
Eat a high-fiber diet. Plant-based foods rich in fiber tend to raise blood sugar levels more slowly than low-fiber plant-based foods. Fiber is in foods such as fruits, vegetables, grains, nuts, seeds, and legumes. A high-fiber diet has been associated with improved blood sugar control. Fiber is also beneficial for promoting heart health and can help reduce the risk of cardiovascular disease. A good amount of fiber to aim for is around 30 grams per day.
- Cinnamon is a more well-known supplement for its potential blood sugar-lowering effects. Some studies have found that cinnamon can help lower fasting blood sugar, as well as help promote normal cholesterol and triglyceride levels.
- Aloe vera may help to lower blood sugar and hemoglobin A1c, as well as improve cholesterol levels. There are few studies on this topic, though.
- Chromium is a mineral that is beneficial for insulin action and carbohydrate metabolism. People with diabetes often have lower levels of chromium than people without diabetes. Supplements containing chromium picolinate have been found to improve blood sugar control.
- Fenugreek can help lower blood sugar by increasing insulin levels. Another benefit is that it can also help lower cholesterol levels.
Diabetes is a disease affecting both genders and all ages. Diabetes is increasing in prevalence worldwide, with many people not even knowing they have it.
Without proper treatment, diabetes can negatively affect a woman’s health. Fortunately, there are many aspects of diabetes treatment which can improve blood sugar control and improve health and wellness. Women can reduce their risks of developing diabetes complications and live happy, healthy lives through a combination of lifestyle changes, medication, and natural treatments.