How diabetes is different for women
Diabetes is a disease that doesn’t discriminate and affects over 300 million people worldwide. Although, us women have a unique set of challenges when it comes to managing this disease.
Women with diabetes have it worse, on average, than men with diabetes.
This shocking inequality was revealed in a 2007 study that found that, between 1971 and 2000, death rates fell among men with the disease, while the death rate among women neither fell nor rose.
So, how is diabetes different for women? Our hormones account for some of the unique challenges that we face, and other societal factors might also account for certain differences such as access to quality and timely healthcare.
Why the disparity? It’s most likely a combination of factors. The bodies of men and women are of course not the same, so differences in physiology are almost certainly involved. In addition, research has suggested that, as a group, doctors treat men and women differently. That gap in care leads to poorer outcomes for women and can even be downright deadly.
Doctors who treat women with diabetes may not understand that sometimes women need to be treated more aggressively than men. Women with diabetes may also put themselves at risk by placing their role as family caregiver ahead of their role as self-caregiver.”
• Death rates for diabetes have fallen in recent years for men but have remained stable for women.
• Hormones and inflammation act differently in women
• Compared with women and men without diabetes, women with diabetes have a sixfold higher rate of heart disease while men with diabetes have only a two to threefold higher rate.
• Women with diabetes are more likely to die of heart failure or a heart attack than men with diabetes.
• Women with diabetes are more likely to have depression than men with diabetes.
• Women with diabetes are more likely to have kidney disease complications than men.
• Women often receive less aggressive treatment for cardiovascular risk factors and conditions related to diabetes.
Living with diabetes: Better care for women
Doctors need to be more aware of the increased risk of heart disease in women with diabetes. Women need to track their blood sugars more carefully, especially around the time of their menstrual periods, to prevent highs and lows.
Talk with a doctor about these strategies to better manage your health:
• More aggressive treatment for high blood pressure and high cholesterol
• Early testing for signs of heart disease
• More frequent monitoring if you had diabetes during pregnancy, gave birth to a baby over 9 pounds, or have polycystic ovary syndrome all risk factors for diabetes
• Self-care that includes sticking to a healthy eating plan and exercising regularly
Taking a more active role in your health is a must. “Women with diabetes need to understand their bodies,” They need to accept that they need to work a little harder. That means frequent blood sugar testing, getting exercise regularly, and getting healthy carbohydrates from fruits and vegetables. It means taking good care of themselves.”
In the general population, women live longer than men, largely because of their lower rates of heart disease. Yet, when women get diabetes, something happens that strips them of this advantage. “The risk for heart disease is six times higher for women with diabetes than those without”. Data also show that women with diabetes are more likely than men with the disease to have poor blood glucose control, be obese, and have high blood pressure and unhealthy cholesterol levels.
This greater risk may stem in part from biological differences in how women and men experience heart attacks. For both, the most common warning sign of a heart attack is chest pain or discomfort in the upper body. However, women are more likely than men to experience only nausea, shortness of breath, and back or jaw pain during a heart attack. If a woman experiences these but doesn’t recognize them as heart attack warning signs, she may not seek treatment, lowering her chances of recovery.
Depression is about twice as common in women than it is in men, and may take a greater toll on women with diabetes than on men with the disease. A landmark 2010 study of women in Archives of Internal Medicine suggested that depression increases the risk of diabetes and vice versa. Other research has shown that women with both conditions are twice as likely to die early as women who have neither diabetes nor depression. These studies didn’t look at men, but a 2006 study in the journal Public Health did, finding that diabetes and depression are associated in women, but not in men.
Women with diabetes should be tested for heart disease risk factors, like high blood pressure or unbalanced blood fats, and treated aggressively.
I also recommended that health history related to female biology should be taken into account more seriously. For example, gestational diabetes and PCOS both raise the risk that a woman will develop type 2 diabetes, as well as other health problems. So women with a history of these disorders should be monitored extra carefully.
The most important take-home message may just be that women with diabetes need to watch out for themselves and that their doctors need to watch out for them. While biology is important, it isn’t everything. There are lifestyle choices women (and men) can make, like exercising regularly and eating well, to improve their health.
Good communication with a good doctor about the effect of diabetes on a woman’s health in particular is also important; doctor and patient should discuss whether medications are needed to get blood pressure and blood fat levels on target. It’s clear that women with diabetes have an extra burden to bear. And it’s just as clear that, male or female, people with diabetes can do a lot to be aware of these issues—and take care to get healthy.
Alli is a consultant cardiologist