Diabetes in women: Understanding the dangers, risk factors, & treatment

Understanding diabetes

Diabetes is a condition that occurs when the sugar levels in the body are too high. Most of the food that a person eats is converted to glucose. The glucose is used by the cells in the body to function. The glucose reaches the cells with the help of a hormone called insulin, which is produced by the pancreas.  Diabetes occurs when the pancreas doesn’t produce enough insulin or the cells become resistant to the effects of this hormone, leading to an increase in the blood sugar levels.

Diabetes has no cure but a person with this condition can still lead a normal life by taking certain measures and precautions.

Types of diabetes

These are the different types of diabetes.

Type 1 diabetes

In this type, the body does not produce enough insulin due to the immune system destroying the insulin-producing cells in the pancreas. Type 1 diabetes is usually more prevalent in children and young adults. People with type 1 diabetes need to take insulin every day.

Type 2 diabetes

This is the most common type of diabetes. It can happen when

• The body doesn’t produce enough insulin
• The body cells become resistant to insulin

Although it can affect people of all ages, it is more prevalent among middle-aged or older adults. Treatments for type 2 diabetes involve making some lifestyle changes and medications.

Gestational diabetes

This type of diabetes only affects pregnant women. It usually goes away on its own once the delivery is complete. However, people who get gestational diabetes are at a greater risk of developing type 2 diabetes in later life.

Prediabetes

Also known as borderline diabetes, prediabetes is a condition where the blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. Prediabetes is an indication that you may develop diabetes in the near future.

Diabetes in women

Diabetes causes more problems in women that it does in men. The risk of developing cardiovascular problems due to diabetes is double in women compared to men. Women are also at a higher risk of developing other complications such as depression, blindness, and kidney disorders.

Here are some other complications that can be caused by diabetes in women.

Diabetes can affect the menstrual cycle

The blood sugar levels fluctuate before the start or during menstruation. If a woman is diabetic then it could result in heavier bleeding during periods and increased appetite. Diabetic women should always monitor their blood sugar levels during periods. If the patient is taking insulin, the dosage may need to be increased before the start or during periods.

Diabetes may increase the risk of UTIs

Approximately half of all the women contract urinary tract infections at some point in their life. However, women with diabetes are at a higher risk of getting UTIs. This happens because increased blood sugar levels decrease the body’s ability to fight off infections. You can prevent UTI’s by keeping your diabetes under control, wearing loose cotton underwear and urinating more often instead of waiting for a full bladder.

Diabetes may increase the risk of yeast infections

Yeast infections are very common in women. However, the chances of getting are more in women with diabetes. This is because high sugar levels provide better conditions for the yeast to thrive. You can prevent yeast infections by maintaining good personal hygiene, avoiding tight-fitting clothes and keep your blood sugar levels under control.

Diabetes may affect libido

If a woman has diabetes, her interest in having sex or to enjoy it reduces. This is because nerve damage, reduced blood flow, hormonal changes, associated with diabetes result in vaginal dryness, which can make uncomfortable and painful. Exercising regularly can improve libido. Vaginal dryness can be cured by the use of lubricants.

Diabetes may affect fertility and pregnancy

Diabetes can help it difficult for a woman to get pregnant. If pregnancy does happen then it could lead to

• Preeclampsia: This is a condition that is characterized by high blood pressure and protein in the urine. If preeclampsia is not quickly treated, it can lead to serious secondary issues such as liver or kidney failure and future heat problems.
• Cesarean section delivery: This is a surgical procedure that involves making incisions in the abdomen and uterus to deliver a baby. Diabetes may increase the risk of cesarean delivery. This is because women with diabetes have impaired uterine contractility. This means they are unable to push.
• Miscarriage: As diabetes may lead to many fetal complications during pregnancy, a miscarriage can happen.
• Birth defects: Babies born to women with uncontrolled diabetes may be born with several defects that can lead to
  • Heart problems
  • Brain and spinal defects
  • Oral clefts
  • Kidney problems
  • Gastrointestinal tract defects
  • Limb defects

Gestational diabetes

This type of diabetes is only seen in pregnant women who did not have diabetes before pregnancy. Gestational diabetes usually affects women in the 24^th to 28^th week of pregnancy. This condition, which usually goes away on its own after delivery, can be managed by eating healthy food and getting adequate exercise.

How is it caused?

The placenta (the tube-like structure which connects the mother to the fetus) makes certain hormones that increase the blood sugar levels during pregnancy. Normally, the body handles this prompting the pancreas to produce extra insulin. If the body is unable to do that, then women get gestational diabetes.

How do you know you have got gestational diabetes?

Gestational diabetes usually doesn’t manifest any symptoms and it is only diagnosed during routine pregnancy tests.  However, in some rare cases, women may experience the classic symptoms of diabetes like

• Polydipsia (excessive thirst)
• Polyphagia (excessive hunger)
• Dysuria (excessive urination)

How is the diagnosis of gestational diabetes made?

The diagnosis of gestational diabetes involves doing the following tests.

Glucose challenge test

A blood sample of the patient is taken and analyzed for glucose. After that, the patient is asked to consume a sugary drink. After one hour, another blood sample is taken and analyzed. Fasting is not required for this test. Here are the potential results of this test.

• A blood glucose level below 140 mg/dL is normal
• A blood glucose level higher than 140 mg/dL indicates gestational diabetes
• A blood glucose level higher than 200 mg/dL indicates type 2 diabetes

Oral Glucose Tolerance Test

The patient needs to fast for at least 8 hours before this test. The patient’s blood sample is then taken every hour for three hours and analyzed. If your blood sugar levels are high in more than one sample, then it is an indication of gestational diabetes.

Treatment

Gestational diabetes usually does not require any treatment as it goes away on its own after pregnancy. However, you can take the following steps to manage this condition during pregnancy.

Eat a healthy, balanced diet

The best way to control gestational diabetes is to eat a healthy diet consisting of a lot of fruits and whole grains. You will be advised against losing weight during pregnancy as the body naturally gains additional weight during that time. However, you should stay away from excessive sugar, refined and processed foods.

Exercise

Being physically active before and during pregnancy has a lot of benefits. Exercising lowers your blood sugar levels and increases the body’s sensitivity to insulin. Additionally exercise also helps reduce some of the discomforts (like back pain and swelling) during pregnancy.  Walking, cycling and swimming are some exercises that are recommended during pregnancy.

Medication

If diet and exercise don’t help then you may need to take certain medications to lower the blood sugar levels. While some women may be prescribed oral medicines to control the blood sugar levels, others may need insulin injections.

Testing after delivery

The patient’s blood sugar levels are again tested after she has delivered the baby. If the results are normal, the patient will again be tested in 6 to 12 weeks. If the results are again normal, the patient will be tested for diabetes once every 3 years.

Who is likely to get gestational diabetes?

Gestational diabetes can affect any women during pregnancy. However, some women are at a greater risk of developing it compared to others. Here are some of the risk factors for developing this condition.

• Age: If the woman is above 25 years at the time of pregnancy she is more likely to develop gestational diabetes.
• Family medical history: A woman is more likely to develop gestational diabetes if one of her close relative (mother, father or sibling) have type 2 diabetes.
• Personal medical history: A woman is at a high risk of developing gestational diabetes if you have prediabetes. You are likely to have gestational diabetes again if you’ve had it during a previous pregnancy.
• Obesity: You are at risk of developing gestational diabetes if have a BMI (body mass index) of 30 and above.
• Ethnicity: African, Hispanic, American Indian and Asian women are at a higher risk of developing gestational diabetes compared to Caucasians.

What are the complications associated with gestational diabetes?

If the blood sugar levels are not managed during pregnancy, it may cause problems for the mother and baby. Gestational diabetes may result in the following complications in babies.

Overweight at birth

The high blood sugar levels in the mother’s blood cross the placenta to reach the baby. This prompts the baby’s pancreas to produce more insulin. All the excess sugar from the mother’s blood is stored in the baby’s body resulting in it being overweight.

Premature birth

Gestational diabetes increases the risk of early labor and this may result in the patient delivering the baby before the due date.

Breathing problems

Babies born to mothers with gestational diabetes may get respiratory distress syndrome, a condition that occurs when the lungs have not fully matured. Such babies will need breathing assistance until their lungs grow stronger. This may also happen in premature babies.

Hypoglycemia

Some babies born to mothers with gestational diabetes develop low blood sugar after birth. This happens because their insulin production is too high due to them being exposed to high blood sugar during pregnancy. Babies with hypoglycemia require immediate attention (like administering glucose through an intravenous solution) as the low blood sugar may result in seizures.

Risk of developing type 2 diabetes

Babies born to mothers with gestational diabetes may result in the baby bring obese and developing type 2 diabetes when he/she gets older.

Prevention

Although there is no foolproof way to prevent gestational diabetes, one may take the following measures to minimize the risk of developing it.

• Adopt a healthy diet: You should eat foods that are high in fiber like fruits, vegetables, and whole grains.
• Be active: As mentioned earlier, being physically active helps with reducing blood sugar levels. It also helps you keep in shape.
• Maintain weight: Although it is not advisable to lose weight during pregnancy, you can shed a few pounds before you get pregnant.

Menopause and diabetes

Menopause is the term given to the state when a woman’s menstruation permanently stops. This is a natural process and every woman undergoes menopause. Menopause also happens when a woman’s ovaries are removed due to various problems such as ovarian cysts, cancer, etc.

The combination of menopause and diabetes may cause a lot of problems. Some of which are

• Fluctuations in blood glucose levels: The decline in the production of certain hormones like progesterone and estrogen can result in the fluctuation of the blood sugar levels. This is because these hormones affect the way the cells respond to insulin. If the woman already has diabetes then the consequences could be serious.
• Infections: As discussed earlier, high blood sugar levels can make a woman more prone to UTIs and yeast infections. After menopause, the risk is even higher as the drop in estrogen makes it easier for the bacteria and yeast to thrive.
• Sexual problems: While diabetes may damage the nerves of the vagina, menopause causes loss of lubrication in the vagina and decreased libido.

TL;DR?

References

 

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