Diabetes teaches you discipline. Diabetes is incurable. But given the tools, a diabetic can manage the symptoms
Women and men are affected differently by diabetes. Diabetic women are at two-time higher risk of heart disease than diabetic men. And have fifty-eight percent greater risk of death from coronary heart disease, thirty percent greater risk of death from cardiovascular disease, and thirteen percent greater risk of death from all causes. Heart disease is the most common complication of diabetes. Women are also at higher risk than men of other diabetic complications such as depression, kidney disease, and blindness. Diabetic women have four-time higher risk of heart disease than non-diabetic women.
Gestational diabetes, diabetes after menopause, urinary tract infection and vaginal yeast infection are typical to women.
Gestational diabetes mellitus
Two to ten percent of non-diabetic women develop gestational diabetes mellitus (GDM) that is high blood sugar during pregnancy. GDM usually develops in later part of pregnancy. Factors which increase the risk of GDM are:
- physically inactive
- obese or overweight
- age above 25
- PCOS (polycystic ovary syndrome)
- an immediate family member with diabetes
- gestational diabetes during a previous pregnancy
- previously delivered a baby weighing more than nine pounds (4.1 kilograms)
For the pregnant women, GDM increases the risk of:
- Surgical delivery (C-section).
- High blood pressure and preeclampsia that can be life-threatening to mother and baby.
- GDM during a future pregnancy.
Gestational diabetes recedes after child birth. But in fifty percent women it develops into type 2 diabetes. Women should take diabetes tests four to twelve weeks after delivery. And then take the tests every one to three years to check that their blood sugar levels are within the healthy range.
GDM puts the baby at increased risk of:
- Early (preterm) birth.
- Serious breathing difficulties.Preterm babies may have respiratory distress syndrome, difficulty in breathing.
- Excessive birth weight.Babies who weigh nine pounds or more are likely to need a C-section and to have birth injuries.
- Baby’s death either before or shortly after birth.
- Hypoglycemia (low blood sugar). Hypoglycemia may cause seizures in the baby. Treatment is quick feeding and an intravenous glucose solution.
- A higher risk of developing obesity and type 2 diabetes later in life.
Reducing the risk of GDM
To reduce the risk of GDM:
- Be at a healthy weight before pregnancy. Lose extra weight if required.
- During pregnancy, gain only the recommended weight.
- Be active.Do thirty-forty minutes of moderate exercise such as brisk walk, pregnancy yoga, and swim, before and during pregnancy.
- Eat healthy.Have more fruits and vegetables of different colors, whole grains, berries, nuts, fish rich in Omega 3 fatty acids such as mackerel, salmon (wild), herring, and tuna, soya, and beans. Avoid saturated fats such as butter, ghee, cheese, sausages, bacon, and salami,
Menopause and Type 2 diabetes mellitus (T2DM)
At menopause, risk of upper body fat (adipose tissue) accumulation increases and women gain weight. Belly fat increase makes body more resistant to the effects of insulin. Also, at menopause body releases insulin less efficiently, and cells respond less well to the insulin. For all these reasons, the risk of diabetes in women after menopause is increased. Early age onset of menopause increases the risk of T2DM later in life.
Body makes less estrogen after menopause. This can cause unpredictable ups and downs in blood sugar. Women may require increased dose of insulin or other diabetes medicines. Managing blood sugar may become difficult because of sleep disruption caused by hot flashes and night sweats. Diabetic women are at a higher risk of vaginal dryness or nerve damage and this can cause problems during sex.
Hormone replacement therapy (HRT) improves body’s response to insulin (insulin sensitivity). But HRT increases the risks of stroke, blood clots, and cancers of the uterus and breast and is not recommended for diabetes treatment.
The drop in estrogen during menopause increases the risk of urinary tract infections (UTI) in postmenopausal women.
Urinary tract infection and diabetes
More than fifty percent of women have a urinary tract infection (UTI) during their lifetime. Women with type 2 diabetes may be at an even higher risk of UTI, and have more frequent and more severe UTIs. UTIs in diabetics are more difficult to treat because these are often caused by resistant pathogens, the Antimicrobial Resistance (AMR).
In those with diabetes, UTIs may lead to serious kidney problems such as renal abscesses, emphysematous cystitis and pyelonephritis.
To reduce the risk of UTIs:
- Drink plenty of water.
- Urinate as often as required, do not hold urine.
- Avoid constipation by consuming adequate amounts of fibers and fruits
- Drink pure cranberry juice
- Wipe front to back after doing toilet.
- Wear cotton underwear.
Vaginal yeast infection, also called candidiasis, is a fungal infection that affects three out of four women during their lifetime. Diabetes reduces body’s ability to fight off bacterial and fungal infections. Type 2 diabetic women therefore get more frequent and more severe episodes of candidiasis. It causes irritation and intense itchiness of the vagina and the vulva, a thick white vaginal discharge that looks like cottage cheese, and burning when urinating or having sex. Once candidiasis sets in, it is difficult to remove because of the resistant pathogen, because of Antimicrobial Resistance (AMR).
To reduce the risk of candidiasis:
- Wear cotton or nature fibers underwear
- Wash daily and dry the skin well, especially after bath and after swimming
- Change tampons or pads frequently.
- After toilet, wipe front to back, to prevent germs from spreading.
- Eat unsweetened yogurt with live cultures (probiotics). Or take probiotics capsules after consulting your doctor
- wearing tight-fitting underwear or pants
- being in wet bathing suit or workout gear for long
- long, hot baths or soaking in a hot tub
- bubble bath, scented soaps, tampons, and sanitary items,and printed toilet paper
- antibiotics not prescribed by doctor
With proper treatment, symptoms of candidiasis go away completely. Untreated candidiasis may delay or even prevent pregnancy.
Diabetes is incurable. But its symptoms can be managed. Healthy weight, exercise, balanced diet rich in fruits, vegetables and fibre, tobacco avoidance and limiting alcohol intake are the ways to manage the symptoms. Complementary and alternative medicine (CAM), herbs, plants, and supplements have limited role in managing diabetes. These can be harmful and should not be taken without doctor’s advice.