Women’s Health: Diabetes and women
Mar 23,2007 00:00 by Douglas_W._Laube_MD_MEd

There are nearly 21 million Americans living with diabetes.  That’s roughly 7% of the population, and about one-third have not yet been diagnosed.  Additionally, there are an estimated 54 million prediabetics.  Diabetes has become a reality for an increasing number of Americans, but many still don’t know the facts about the disease.

 

Douglas W. Laube, MD, MEd, President, The American College of Obstetricians and Gynecologists 

Diabetes is caused when insulin, a hormone that helps glucose from digested food nourish cells in the body, is in short supply or is not functioning properly.  The unused glucose builds up in the blood stream to abnormal levels.  Diabetes is diagnosed when screening tests show blood glucose to be higher than normal. 

Diabetes falls into three main categories:

Type 1 (juvenile-onset) diabetes develops when the body’s immune system destroys the cells in the pancreas that make insulin.  Type 1 diabetics take insulin shots to control blood glucose levels.

Type 2 (adult-onset) diabetes accounts for 90% to 95% of diagnosed cases of diabetes.  It usually begins when the body becomes resistant to the effects of insulin.  The pancreas must produce more insulin to keep glucose levels normal, but eventually the demand for insulin becomes too great and diabetes develops.  Type 2 diabetes can be managed with insulin shots or medications that lower blood glucose levels, or through diet and exercise, which can reduce or eliminate the need for additional medication.

Gestational diabetes, in which the hormones of the placenta limit the effectiveness of insulin, occurs in 2% to 5% of pregnant women.  This form of diabetes usually subsides after delivery. 

Symptoms of diabetes can include increased thirst or urination, constant hunger, blurred vision, extreme fatigue, recurrent infections, and sores that are slow to heal.  Uncontrolled diabetes can lead to severe liver damage, nerve and blood vessel damage, blindness, amputation, birth defects or stillbirth, and thyroid problems.  Women can lower their risk of developing diabetes by reaching and maintaining a healthy weight, eating a diet of healthy and low-fat foods, getting regular exercise, and avoiding smoking.

ACOG recommends that women over 45 should be tested for diabetes every three years.  Earlier or more frequent testing may be needed if additional risk factors are present, such as being overweight, physical inactivity, a family history of diabetes, high blood pressure, low HDL (“good”) cholesterol levels, high triglyceride levels, previous abnormal glucose screening results, or a history of gestational diabetes or giving birth to a baby weighing more than nine pounds.