Type 2 diabetes poses special challenges for women
By Hope Williams, RD, CD, CDE, CLS
Ministry Medical Group, Rhinelander
Diabetes affects 29 million Americans–13.4 million women and 15.5 million men. Yet, despite the fact that women are somewhat less likely to be diagnosed with diabetes, they are more likely to suffer a number of serious diabetes-related health problems including heart disease, complications of pregnancy and depression.
Diabetes involves a problem with the way the body processes insulin, a hormone produced by the pancreas that allows sugar circulating in the blood to enter cells where it is converted into energy. Type 1 diabetes, accounting for about 10 percent of cases, typically develops in childhood or adolescence. In Type 1 the pancreas no longer produces insulin and patients need regular insulin injections to stay healthy.
If the pancreas doesn’t produce enough insulin, or if our bodies become resistant to insulin, too much sugar (also known as glucose) is left circulating in the bloodstream, setting the stage for Type 2 diabetes.
Female hormones may explain some of the excess risk women face with Type 2 diabetes. The female hormones estrogen and progesterone increase the body’s sensitivity to insulin.
When estrogen and progesterone levels drop, during menopause for example, insulin sensitivity may also be lowered. Fluctuations in hormone levels during the menstrual cycle can affect younger women, causing spikes in blood sugar levels. Women diagnosed with Type 2 diabetes or who have prediabetes need to pay special attention to their insulin levels when hormone levels are unstable.
Heart Disease: Diabetes increases the risk for heart disease for both men and women, but women face even higher risks. According to the American Diabetes Association (ADA), compared with women who do not have diabetes, women with diabetes are twice as likely to suffer a second heart attack after a first one and four times as likely to suffer from heart failure.
Pregnancy and childbirth carry additional risks for both mothers and their babies when the mother has diabetes. Risks include miscarriage, birth defects and early delivery. Pre-pregnancy planning and working with your doctor to keep blood sugar levels under control during pregnancy can minimize these risks.
Gestational diabetes can develop in women during pregnancy. Although it usually resolves after the baby is born, it’s important that gestational diabetes be carefully managed.
Depression is twice as common in women as in men, but women with diabetes face an even higher risk.
One study found that women who suffered from depression had an increased risk of developing diabetes. Other studies have shown that having both diabetes and depression doubles the risk of an earlier death.
The challenge may be daunting but there are steps women can take to lower their risk of developing Type 2 diabetes or of controlling, or even reversing, Type 2 if they are already diagnosed. It’s essential to focus on the controllable risk factors.
Losing weight: Being overweight or obese increases your risk of developing Type 2 diabetes. A study using data from the Nurses Health Study concluded that “excess body fat is the single most important determinant of Type 2 diabetes.”
One study found that a weight loss of just 7 to 10 percent (14 to 20 pounds for someone weighing 200 pounds) cut the risk of developing Type 2 diabetes by 50 percent.
Some patients who succeed in getting their weight within a healthy range find they no longer need medication to control their blood sugar.
Getting regular exercise: Leading a sedentary lifestyle is one of the major risk factors for developing Type 2 diabetes. You don’t need to be an athlete or join a fancy gym to get the exercise you need. Start by walking for half an hour a day. You can break it up into two 15 minute walks if it’s difficult to walk that far in the beginning. Aerobic exercise increases the effectiveness of your insulin, improves blood flow and strengthens your heart.
Healthy eating: Avoid highly processed carbohydrates such as cakes, cookies, chips and sugary drinks and fats and limit deli meats and red meat. Instead, focus on a diet rich in fruits and vegetables, fish, whole grains, poultry, beans, nuts and seeds. Olive oil, canola oil, peanut oil, nuts and avocados can all provide the healthy fats you need.
Type 2 diabetes can sneak up on you. Watching your weight, getting regular exercise, eating a healthy diet and not smoking will go a long way to protecting you.
Hope Williams, RD, CD, CDE, CLS, is a Health Coach with Ministry Medical Group, part of Ascension.