Women and Diabetes: What to Know

We’ve all heard the saying that “men are from Mars, women are from Venus.” It’s so true that women and men differ, and in a multitude of ways. When it comes to health care or, more specifically, management of disease, there are several differences that have been noted by researchers in terms of how women are treated compared with men. According to an article published in 2012 in the journal EMBO Reports:

• Women who have had a heart attack receive less guideline-based diagnosis and less-invasive treatment than men.

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• Women who have heart failure receive fewer guideline-based treatments than men, and are less likely than men to have a heart transplant.

• Women start dialysis later than men, and have fewer kidney transplants, too.

• Women with rheumatoid arthritis are referred later to an arthritis clinic compared to men.

• Thyroid diseases are more common in women than in men.

• Alzheimer’s disease is more common in women than in men.

On the other hand:

• Osteoporosis and depression are less frequently diagnosed in men than in women.

• Cardiomyopathy (disease of the heart muscle) is more common in men than women.

• Men are more likely to develop Parkinson’s disease than women.

• Men are more likely than women to get and die from cancer.

Diabetes and gender differences
What about diabetes? Is diabetes different for a woman than for a man? And if so, how? According to a study published in 2016, when it comes to prediabetes, physical activity (or lack thereof) is more predictive of prediabetes in men, while waist circumference is more predictive of prediabetes in women. While diabetes may affect genders pretty much equally, according to data from Womenshealth.gov, diabetes is “different” for women and men (perhaps, not surprisingly). For example, women who have diabetes have:

• A higher risk for heart disease.
• Lower survival rates and a poorer quality of life after a heart attack.
• A higher risk of blindness.
• A higher risk of depression (and depression is a risk factor for diabetes in women).

Many of these differences are based in biology (for example, differences in levels of sex hormones, good and bad cholesterol, and level of inflammation). Symptoms can vary between the genders, too. Diabetes complications are more difficult to diagnose in women. Also, some researchers believe that women have less access to health care and a lower quality of health care, as well. In a 2005 study in Diabetes Care, women with diabetes were less likely than men to receive medication for heart disease risk factors, such as high LDL (“bad”) cholesterol. And, discouragingly, the death rate for men with diabetes fell between 1971 and 2000 (a good thing, for sure!), but not for women.

For all the women
If you’re a woman who has diabetes, it can’t be overemphasized how important it is to take care of — and take charge of — your health. I’m hoping that the information below is helpful for you in terms of understanding your diabetes and steps to take to best manage it.

Know the symptoms of diabetes. Many diabetes symptoms are the same in women as in men, including:

• Weight loss
• Increased thirst and hunger
• Frequent urination
• Blurry vision
• Fatigue
• Cuts or sores that don’t seem to heal
• Numbness or tingling in your hands or feet
• Sexual dysfunction

Diabetes symptoms that are unique to women include:

• Yeast infections (both vaginal and oral)
• Urinary tract infections
Polycystic ovary syndrome (PCOS)

Of course, the above symptoms don’t necessarily mean that you have diabetes, as these can be caused by other factors. Rather, they’re symptoms linked with having diabetes. And, it’s always important to remember that, in the case of Type 2 diabetes, there may be no symptoms at all!

Know your heart disease risk factors. Heart disease is the leading cause of death in both women and men who have diabetes. But heart disease is different for women.

• Get your blood lipids (cholesterol and triglycerides) checked at least once a year (or more often, as recommended by your provider). Know what your goals are, and find out what you can do if your lipids aren’t at goal. Changes in your food choices, increasing physical activity, losing weight, and taking medication may be part of your treatment plan.

• Make sure your blood pressure is checked at every doctor’s visit. As with your blood lipids, if it’s not at goal (be sure to ask what your goal is), find out what you need to do to get it there. The treatments for high lipids, mentioned above, apply to high blood pressure, as well.

• Be aware of signs of a possible heart attack. While women are less likely to have a heart attack than men, you should still know the symptoms so that you can seek help right away. Symptoms include chest pain, for sure, but women may be more likely to have discomfort in the neck, jaw, shoulder, or abdomen; pain in one or both arms; nausea or vomiting; sweating; lightheadedness; or fatigue.

Your diabetes will likely change over time. In other words, you may notice that your blood sugar levels climb during certain times in your life, including the onset of menstruation or menopause, starting certain types of birth control pills, and during pregnancy. During these times, you will most likely need to tweak your treatment plan. Women with Type 1 diabetes (and some with Type 2) will probably need higher insulin doses, for example. Changing your eating and activity plans can help if you’ve gained weight during menopause. Making sure to get enough sleep and learning how to better handle stress are other important steps to take, too.

Plan for pregnancy. Women who have diabetes can and do have successful pregnancies. But planning is key, and planning should start long before you become pregnant. High blood sugar levels during the early weeks of pregnancy can raise the risk of birth defects, miscarriage, and diabetes complications. These risks can be avoided by keeping blood sugar levels well controlled three to six months before you become pregnant. In addition, seeking excellent prenatal care is important, as well.

Seek help for eating disorders. Girls and women who have Type 1 diabetes are twice as likely to develop an eating disorder as those without diabetes. Eating disorders include bulimia, binge eating disorder, and anorexia. Women who have Type 1 diabetes may experience “diabulimia,” a complex disorder that may involve restricting or withholding insulin as a way to lose weight. Eating disorders are especially dangerous for women with diabetes, as they can lead to diabetic ketoacidosis, higher HbA1c levels, more infections, higher rates of complications, and more trips to the ER.

Having diabetes can be stressful and challenging. However, it can be managed, and newer treatments are available to make it at least a little bit easier! Realize that most of diabetes management is up to you. Learn about your diabetes and how to take care of yourself. Find a health-care team that you can partner with. And don’t delay seeking treatment if you aren’t feeling well or are having symptoms that are new or unusual. Speak up if you don’t think you’re getting the care or treatment that you need.

Living with Type 1 diabetes, Amy Mercer has developed something of a love-hate relationship with candy. Bookmark DiabetesSelfManagement.com and tune in tomorrow to read more.