Diabetes and women: What you need to know

Curious about the relationship between diabetes and women?

About one in nine adult women in the United States currently have diabetes, totaling 15 million nationwide. While more men than women have diabetes, diabetes affects women differently and they may experience more complications.

During Women's Health Month — and all year-round — women can take steps to protect their health and reduce their risk of diabetes and its complications. Here are the key details to know.

What is diabetes?

Diabetes is a condition in which the body either does not make insulin or does not use insulin effectively, leading to high levels of sugar in the blood. Symptoms of diabetes include frequent urination, increased thirst and/or hunger, fatigue, dry skin, slow-healing sores, blurry vision, increased infections and unintended weight loss.

Over time, diabetes — especially inadequately controlled diabetes — can increase the risk of heart attack, stroke, blindness, amputation and kidney failure. Research indicates that women may have higher rates of some of these complications. In addition, diabetes can cause problems for women and their babies during pregnancy.

The good news is that with regular monitoring and treatment, including healthy eating and regular exercise, most women with diabetes can avoid or reduce complications and live healthy lives. This includes getting pregnant and having healthy babies, if they choose.

Three types of diabetes women may experience

Three types of diabetes affect women. In addition to Type 1 and Type 2 diabetes, women may also develop gestational diabetes during pregnancy.

Type 1

This disease causes the immune system to attack the pancreas and causes it to stop making insulin. The body needs insulin to turn glucose (sugar) into energy, and without it, sugar builds up in the blood. Type 1 diabetes is the least common type of diabetes, accounting for less than 5% of cases. The condition can come on suddenly; it often develops during childhood but can occur at any age.

Type 1 diabetes runs in families, and research suggests that certain viral infections or illnesses can trigger the immune response that damages the cells that produce insulin. Type 1 diabetes affects slightly more men than women. However, women may experience more complications, especially heart-related complications.

Type 2

Type 2 diabetes is the most common type of diabetes — and cases are on the rise. More than 90% of all diagnosed cases of diabetes are Type 2, and many more people have the disease and do not know it. Type 2 diabetes can develop at any age but the risk rises as people age.

As many as one in three adults over age 65 may develop Type 2 diabetes. Men are at higher risk for Type 2 diabetes than women. However, after menopause — especially menopause that occurs before age 40 — women's risk of Type 2 diabetes and its complications rises.

Gestational diabetes

This condition occurs during pregnancy when when hormones from the placenta make it harder for your body to use insulin, leading to high blood sugar levels. It usually develops around the 24th week of pregnancy and affects about 5% to 9% of pregnancies. Factors like obesity, being over 35 years old, having a family history of diabetes, or having a history of gestational diabetes in a prior pregnancy increases the risk of developing this condition. Most women with gestational diabetes don’t notice any symptoms, which is why regular prenatal care and screening are essential.

If untreated, gestational diabetes can lead to complications for both mother and baby. For mothers, it increases the risk of preeclampsia, having a larger baby and subsequent increased risk for needing a C-section, and developing Type 2 diabetes later in life. Babies born to mothers with gestational diabetes also have increased risks such as being born larger than average, experiencing low blood sugar or breathing problems at birth potentially requiring intensive care, as well as having a higher chance of developing obesity or Type 2 diabetes.

Managing gestational diabetes involves eating a balanced and healthy diet, staying active, monitoring blood sugar levels, and sometimes taking insulin. With proper care, women with gestational diabetes can maintain normal blood sugar levels and have healthy pregnancies.

How hormones affect diabetes and women

Women experience changes in hormone levels during the menstrual cycle, pregnancy, breastfeeding and also around menopause. Research suggests these changes may affect blood sugar control and the risk for diabetes. Some examples include:

• Menstrual cycles: Research has shown a relationship between estrogen levels and how well the body uses insulin. Some studies suggest that women with diabetes may have more difficulty controlling blood sugar levels during the second half of the menstrual cycle (after ovulation) when estrogen decreases and progesterone increases.
• Pregnancy: Hormone levels change during pregnancy, which can affect blood sugar levels. Women with diabetes may find they need to adjust their medications or their eating and exercise habits during pregnancy to reduce the risk of problems for both themselves and their babies.
• Breastfeeding: Breastfeeding has many benefits for both mother and baby, including reducing the risk of diabetes. Women who develop gestational diabetes are less likely to develop Type 2 diabetes later if they breastfeed after giving birth. It's important to check blood glucose levels before and after nursing to keep levels in the normal range.
• Menopause: Women's risk of Type 2 diabetes increases after menopause or surgery to remove the ovaries. This may be related to lower estrogen levels, weight gain or lack of sleep, all of which can affect blood sugar levels. Women should check their blood sugar often and work with their healthcare team to adjust medications as necessary. Some research suggests that hormone replacement therapy after menopause may help reduce blood sugar levels in women with Type 2 diabetes.

Throughout life, eating healthy foods (including fruits, vegetables and whole grains), getting regular exercise and avoiding smoking can reduce the risk of diabetes and its complications for women. Regular medical care and monitoring for high blood sugar, cholesterol, blood pressure and other risk factors are also key to maintaining overall health at all stages of a woman's life.