Women often face threats from diabetes that differ from men – from the development of type 2 diabetes to the complications it can create.
Women diagnosed with type 1 or 2 diabetes may have different symptoms or complications with unmanaged blood sugars. Additionally, women are at risk for gestational diabetes during pregnancy and women with diabetes will also experience increased insulin resistance during pregnancy.
“Diabetes, especially type 2, is more common in men, but we tend to see more complications in female patients,” said Avera clinical dietitian Morgan Willard MS, RD, LN, Avera Care Coordination. “Men are twice as likely to develop type 2, yet rates of obesity in men and women are somewhat the same.”
Women with Diabetes Have Increased Risk for Heart Disease and Other Complications
Diabetes increases the risk of heart disease by roughly four times in women. Heart disease remains America’s No. 1 health threat, and it is considered the most common diabetes complication. What’s worse is that women often face outcomes after a heart attack that are much worse. Women are also at higher risk of other diabetes-related complications, including:
- Blindness
- Kidney disease
- Depression
“Diabetes is different for women. We also know some women are at higher risk of developing it. Changes in hormonal activity over the course of a woman's life play a crucial role in shaping diabetes risks,” Willard said. “American Indian, Alaska Native and Asian/Pacific Islander women are more likely to have it. The same is true for African American as well as Hispanic/Latina women.”
Managing diabetes changes over time for women.
Early Signs of Diabetes in Women Differ
Some early signs of diabetes include feelings of thirst or more frequent trips to the bathroom. Early symptoms more common for women are things like:
- Chronic yeast infections
- Recurrent urinary tract infections
- A decreased sex drive and heavier menstrual periods
- Worsening vision or skin discoloration especially darker areas in the neck, groin and armpits
- Unintentional weight loss or weight gain after menopause
She said while more than half of women experience UTIs, the risk is higher with diabetes due to:
- High blood sugar levels
- Poor circulation, which can impact your strength in fighting infection
- Bladders that don’t empty completely create opportunities for bacteria to grow
Health care providers who focus on women’s health can often help manage these changes.
Menstrual Cycles and Menopause Affect Blood Sugars
“Hormone changes may impact your blood-sugar level,” said Willard.
Progesterone levels can go up in the later part of many menstrual cycles, and in turn, an increase in insulin resistance happens. “It’s helpful for women to be aware of this fact so they can be extra mindful of diet or monitor blood sugar more closely during this part of their cycles,” Willard said.
Menopause is another time of shifting hormones. The sharp decline of the hormone estrogen can lead to changes that can affect body weight, fat distribution and how well blood sugar is processed.
“Menopause itself has not been found to raise the risk of diabetes. However, sleep disturbances, hormonal changes and weight gain can make managing blood sugar harder for older women,” Willard said.
Check with your doctor on diabetes medicine dosage. She said that heart disease risk goes up after menopause, so make heart-healthy choices can help you manage.
“Stay on track by checking your blood sugar often, eating a healthy diet, and being as active as possible,” Willard said. “These steps can help you be your healthiest and feel your best.”
Diabetes Can Make Pregnancy More Difficult
If you want to have a baby, diabetes can make it harder to get pregnant. If you have high blood sugar during the pregnancy, it’s more likely you can face conditions such as:
- Preeclampsia (high blood pressure)
- Delivery by cesarean section (C-section)
- Miscarriage or stillbirth
High blood sugar also can cause birth defects. “If you have high glucose while pregnant, it can increase chances of premature birth, a baby that weighs too much and creates a harder delivery,” Willard said. It can also create hazards such as babies who have breathing problems or low blood sugar shortly after birth.
Prior to pregnancy, women with diabetes should work closely with their health care team. Blood sugar control before conception and throughout pregnancy provides the best chance of having a healthy pregnancy and birth.
“Your blood sugar can change quickly, so it’s important to be checking blood sugar regularly,” she said. “Adjust diet, activity and medication with the help of your OB provider.”
Pregnancy Changes Your Insulin Resistance
Healthy women without diabetes may get gestational diabetes, which causes high blood sugar during pregnancy. This type of diabetes affects about 2-10% of pregnancies in the United States.
Women with any kind of diabetes will have increased insulin resistance during pregnancy, which makes managing blood sugars more difficult.
“In the last half of the pregnancy, insulin resistance increases considerably,” Willard added. “It can become severe, especially in women with gestational diabetes and type 2 diabetes.”
Women at risk for gestational diabetes are often:
- Older than 25
- Overweight or obese
- Part of a family with type 2 diabetes history
“It’s critical to work up a diabetes management plan with your doctor,” Morgan added. “A treatment plan for gestational diabetes can include special meal plans, physical activity and it may also include blood glucose testing and medication if needed. This condition often goes away after the baby is born, but about 50% of women with it develop type 2 diabetes.”
Managing Blood Sugar Levels
Managing blood sugar levels is important for any type of diabetes.
The A1C test is most commonly used to determine healthy levels.
“In women, an A1C test of 5.7% or below is considered normal,” Willard said. With a diabetes diagnosis your A1C may be higher. Your provider will discuss goals for a healthy A1C that works for your type.
Learn more about diabetes and how to manage it.
