Managing Diabetes: A Comprehensive Guide for Women

Diabetes is a chronic medical condition that affects how the body processes blood sugar (glucose). There are two types of the disease – type 1 diabetes (T1D) and type 2 diabetes (T2D). Both types cause blood sugar to remain too high, but their mechanisms of action are different. Type 1 diabetes is an autoimmune condition where the body mistakenly attacks the cells in the pancreas that produce insulin, the hormone responsible for moving glucose into cells to be used for energy. In T1D, the body doesn’t make enough insulin (or any at all), and it requires life-long exogenous insulin therapy. Most people are diagnosed with T1D during childhood, but it can occur in adulthood too.

Type 2 diabetes occurs when the body develops a resistance to insulin and cells in the muscles, fat, and liver don’t respond as they should. In T2D, insulin gradually becomes less effective at moving glucose out of the bloodstream and into cells. It can be treated with lifestyle modifications and non-insulin medications, and its usually diagnosed in adults. Important risk factors for T2D include: being 45+, having a family history of T2D, and being overweight or obese (BMI of 25 or greater). Other notable risk factors for T2D are: menopause, high blood pressure, high cholesterol, lack of physical activity, PCOS, and a personal history of heart disease and stroke. About 15 million women have diabetes, and most of them (~90%) suffer from type 2 diabetes – so this is the type of diabetes we’re talking about in this article. Gestational diabetes is a special kind of T2D that can happen during pregnancy (but goes away afterward). It can impact the long-term health of mom and baby and can raise the risk of developing T2D later in life.

Over time, untreated T2D can cause a myriad of other health problems. Excessive glucose in the bloodstream can damage nerves and blood vessels and lead to loss of feeling and tingling (especially in the feet and lower legs), heart disease (including heart attack and stroke), kidney damage, and blindness. T2D is a big, bad deal. And there really is now other way around it. Except, there is.

Modern-day medicine has screening tools that allow health care providers to pick up on prediabetes (the precursor to diabetes) earlier than ever, and there are numerous common-sense and low-cost treatment options that almost everyone can access – like eating better, exercising more, and losing weight.

T2D impacts men and women, but it affects people who possess the XX chromosomes in some unique ways.

The Unique Impact of Diabetes on Women

Diabetes is more dangerous for women. Why? Scientists don’t fully understand the reason, but one popular idea is that hormonal fluctuations that women experience during certain phases of their lives – menstruation, pregnancy, menopause – changes the body’s response to insulin.

Here are some of the ways diabetes is more dangerous for women:

Increased risk of heart disease

Diabetes can double a man’s risk of developing heart disease, but it raises a woman’s risk even more. But that’s not all. Women with diabetes have a lower survival rate following a heart attack too.

Higher risk of vision loss and blindness

Women with diabetes experience loss of vision and blindness more often than men with the disease.

Mental health problems

For some reason, diabetes makes women more likely to develop depression and other mental health conditions.

Reproductive health issues

Women diagnosed with diabetes have a greater chance of experiencing sexual health problems, including infertility and infections. Diabetes increases the risk of infection in everyone, but it affects women even more. Women with diabetes get more vaginal yeast infections and UTIs, which are common complications of untreated diabetes. True, both infections are usually more uncomfortable than harmful, but UTIs can spread to the kidneys and cause a more serious infection (that may not be noticed by someone with diabetes.) Also, in older people, UTIs can cause sepsis – a dangerous blood infection.

Common Symptoms of Diabetes

Unfortunately, diabetes can develop without many (or any) overt symptoms. But when symptoms do arise, these are some of the most common ones:

• Experiencing extreme thirst
• Urinating more than usual
• Feeling tired and rundown
• Having blurry vision
• Being hungrier than usual
• Losing weight without trying
• Having dry, itchy skin
• Getting sores that are slow to heal
• Feeling a tingling sensation in hands or feet
• Getting more UTIs or vaginal yeast infections

How Doctors Diagnose Diabetes

Providers use a variety of blood tests to determine whether or not a person has diabetes.

A random plasma glucose test measures your blood sugar and can be given at any time without fasting. A result of 200ml/dL (milligrams per deciliter) indicates diabetes, especially with other symptoms.

A fasting plasma glucose test checks blood sugar after a period of fasting. Less than 100 mg/dL is normal. A result of 126 mg/dL is considered diabetes.

An A1C test measures average blood sugar levels over the past few months. It’s considered the ‘gold standard’ of tests for diabetes. 6.5% or higher means a person has diabetes.

Tips for Treating and Managing Diabetes

The ultimate goal of any treatment or management plan for diabetes is to lowering short term and long term blood sugar and keeping it low. There are several available options for accomplishing this endpoint, but most providers recommend lifestyle changes first – losing weight (if necessary), eating better, and getting more physical activity. After that, a person with diabetes can try one or more medicines approved to treat the disease.

Exercise

Regular activity is important for the overall health for everyone, but it’s even more important if someone has diabetes. It naturally lowers blood sugar, improves blood flow and blood pressure, burns calories and helps with weight loss, increases energy and boosts mood, and helps alleviate stress. Even without weight loss, exercise can improve the body’s ability to use insulin (increase insulin sensitivity) and delay the progression from prediabetes to full-blown diabetes.

Diet

The key with T2D is to include a variety of healthy, whole foods that support stable blood sugar levels and inhibit spikes of high blood sugar. Eating a healthy diet usually means: smaller portions and more high-fiber foods, lean proteins, non-starchy fruits and vegetables, healthy fats, complex carbs, and low-fat dairy.

Weight loss

Both diet and exercise play roles in achieving and maintaining a healthy weight, which is also critical in managing diabetes. In fact, losing as little as 5% of body weight can provide health benefits and make a noticeable difference in a person’s numbers.

Stress Relief

Stress can elevate blood sugar, so it’s a good idea for people with diabetes to incorporate mindfulness practices into their routines – yoga, tai chi, meditation.

Medicine

If lifestyle modifications alone aren’t effective for improving blood sugar levels, a variety of medicines can be used.

• Metformin is usually the first medication prescribed for T2D. It works by reducing glucose production in the lover and improving the boy’s sensitivity to insulin. Metformin also promotes modest weight loss, has few side effects, and is cheap.
• GLP-1 receptor agonists are a newer class of drugs that slow digestion, which helps regulate blood sugar levels. They are associated with weight loss and may reduce the risk of cardiovascular events and kidney disease too.
• SGLT-2 inhibitors block the return of glucose into the bloodstream in the kidneys, which allows it to be eliminated in the urine. These meds might also reduce the risk of heart attack and stroke in people with higher risk for these cardiovascular events.
• There are several other drug types, and it will be up to you and your provider to make a treatment plan and choose the best one(s) to try.

Monitoring

It’s important to keep track of blood sugar trends when trying to manage this condition. Checking blood sugar on the regular or, better yet, wearing a continuous glucose monitor can help a person with diabetes recognize how certain foods and activities impact their numbers.

Conclusion

The eighth-leading cause of death in the United States, diabetes is one of the most devastating chronic diseases in the world, and up to 80% of cases are preventable with lifestyle changes alone – achieving a healthy weight, getting more physical activity, quitting smoking, and eating better.

In 2019, more than 37 million people in the US had diabetes and more than 700 million people around the world are estimated to have diabetes by 2025. In 2017, diabetes cost the US health care system 237 billion dollars and the global health expenditure for diabetes was over 966 billion dollars – just shy of a trillion bucks.

Diabetes is even more burdensome to women. It increases their risk of serious health problems (like heart disease, vision loss, and mental health issues) more than men, and certain life events unique to women – menstruation, pregnancy, and menopause – increase their chances of developing T2D at some point.

But effective management of diabetes is possible. Especially, if you remember that small, consistent efforts can make a big difference when it comes to diabetes. You are well on your way if you can remember the five “M”s too: Move (exercise). Masticate (diet). Mindfulness (lower stress). Meds (prescription treatments). Monitor (screen and keep track).