Blood sugar control benefits heart health

Women, in particular, suffer from more serious cardiovascular complications and other diabetes-related complications.

More than 34 million Americans have diabetes and 88 million have prediabetes, many of whom don’t even know it, according to the CDC. This results in direct health care costs of more than $235 billion per year and $90 billion in lost productivity.1

Although more men are diagnosed with diabetes than women, diabetes affects women differently and women often suffer from more serious complications, which is why blood sugar control is essential.2

Symptoms

Many symptoms of diabetes are the same for men and women, such as blurred vision, excessive hunger or thirst, fatigue, frequent urination, fruity breath, headache, tract infections lower respiratory and urinary tract disorders, recurrent skin conditions, slow-healing wounds, and unexplained weight loss. However, women often present with decreased libido, oral and/or vaginal yeast infections and polycystic ovary syndrome.3.4

Risk factors

Several factors increase the risk of women developing diabetes. These include belonging to certain ethnicities or races, such as being Asian American, African American, Alaska Native, Native American, or Pacific Islander; being obese or overweight; be over 45; have a family history of diabetes; having developed gestational diabetes during pregnancy; have high blood pressure and/or high cholesterol; have a history of heart disease or stroke; have polycystic ovary syndrome; and lead a sedentary life.3

Complications

Although women experience many of the same complications as men, such as diabetic retinopathy, dietary damage, heart and kidney disease, and neuropathy, they also experience different and/or greater complications. These include in particular the following:

heart disease. The most common complication of diabetes is heart disease. Although men with diabetes develop heart disease at about twice the rate of those without diabetes, women develop heart disease at 4 times the rate. They also have poorer outcomes than men after a heart attack.2

Hormonal changes. Women of childbearing age experience hormonal changes every month. These changes make it difficult to regulate blood sugar. The same is true during pregnancy and progresses through menopause. As blood sugar increases, libido decreases. High blood sugar also leads to vaginal dryness, making intercourse uncomfortable and even painful.2

Pregnancy. Diabetes can cause problems for both mother and child during pregnancy. Poor blood sugar control during pregnancy can increase the risk of breathing problems, low blood sugar at birth, birth defects and premature delivery and can also cause the baby to be overweight, leading to birth complications. Women with diabetes generally have a harder time getting pregnant. They also have a higher risk of developing preeclampsia or having a caesarean section, miscarriage or stillbirth.2

Urinary tract and yeast infections. Decreased circulation and excessive blood glucose levels combine to reduce the body’s ability to fight infection. This can lead to recurrent oral and vaginal yeast infections, as well as urinary tract infections. Additionally, many women with diabetes have bladders that do not empty completely, creating an environment for bacteria to grow.2

Gestational Diabetes

Gestational diabetes develops when a woman who does not have diabetes has high blood sugar levels during pregnancy. It occurs in approximately 2% to 10% of pregnancies in the United States each year. Gestational diabetes can affect any woman, but the risk is higher when a woman has a family history of type 2 diabetes, is obese or overweight, or is over 25 years old.2

Gestational diabetes usually goes away after delivery; however, approximately 50% of these women develop type 2 diabetes. It is important to retest for diabetes between 4 and 12 weeks after childbirth, and then every 1 to 3 years thereafter.2

What women can do

The goal of diabetes for both men and women is to keep hemoglobin A1c and blood sugar levels at or below target levels. Because diabetes is not a universal disease, the management of the disease is different in different individuals, although the mechanisms used are the same. Management includes proper diet, exercise, hydration, medications, avoidance of alcohol and smoking, and proper planning.5

Women also have special circumstances that require extra effort. Here are a few things to keep in mind:

Diet. Patients need to know how different foods affect the body. Counting carbohydrates, coordinating meals and medications, and choosing the right food combinations for well-balanced meals are all important in managing diabetes.5

Exercise. Patients should discuss an exercise program with a clinician, stick to an exercise program, and know the ideal blood sugar level before beginning exercise.5

Medications. Patients need to know what medications are being taken and when and stick to the schedule. They should also understand the proper storage of medications; insulins are stored in the refrigerator, for example. Patients should report any medication-related problems to a pharmacist or doctor. They should also be careful with new medications, as some can affect blood sugar levels.5

Plan ahead. It is of utmost importance to be prepared when managing diabetes. Patients should always have enough medication on hand. If a drug makes the difference between life and death, they need to make sure there is enough to cover any emergencies that may arise that have
a plan for transporting medications safely. They should also have a plan in case of illness. The body’s defense mechanisms that help fight disease can also raise blood sugar. The disease can also affect appetite, making blood sugar control much more difficult. Patients should test themselves often when illness occurs and adjust management accordingly.5

Special circumstances of women. Hormone levels fluctuate before, during and after a menstrual cycle. It is important to be proactive and try to distinguish patterns of blood sugar changes that correlate with hormonal changes. Adjustments to a diabetes treatment plan may be needed during these times to keep blood sugar levels low. Also, the same goes for pregnancy and menopause, although these can be more gradual and longer term.5

About the Author

Kathleen Kenny, PharmD, RPh, has over 25 years of experience as a community pharmacist. She is a freelance clinical medical writer based in Homosassa, Florida.

References

1. Diabetes translation division at a glance. CDC. Updated August 21, 2020. Accessed June 13, 2022. https://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm

2. Diabetes and women. CDC. Updated December 1, 2020. Accessed June 13, 2022. https://www.cdc.gov/diabetes/library/features/diabetes-and-women.html

3. Gotter A. How diabetes affects women: symptoms, risks, and more. Health line. April 27, 2017. Accessed June 13, 2022. https://www.healthline.com/health/diabetes/symptoms-in-women

4. Livadas S, Angnostis P, Bodou JK, Bantouna D, Paparodis R. Polycystic ovary syndrome and type 2 diabetes mellitus: a review of the state of the art. World J Diabetes. 2022;13(1):5-26. doi:10.4239/wjd.v13.i1.5

5. Diabetes management: how lifestyle and daily routine affect blood sugar. Mayo Clinic. June 3, 2022. Accessed June 14, 2022. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20047963

Rachel J. Bradford