Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, which usually occurs during childhood or adolescence, and type 2, the most common form of the disease, which usually occurs after the age of 45, but is increasingly being diagnosed in children and adolescents.
Diabetes is a unique condition for women. When compared with men, women have a 50 percent greater risk of diabetic coma, a condition brought on by poorly controlled diabetes and lack of insulin. Women with diabetes have heart disease rates similar to men, but more women with diabetes die from a first heart attack than do men with diabetes.
Women with diabetes experience congestive heart failure compared to those with normal blood sugar. The prevalence of chest pain, heart attack, and coronary heart disease are all 4 to 5% higher in women with diabetes than in women without, and 6.3% of women with diagnosed diabetes suffer stroke compared to 2.1% of women with normal blood sugar levels.
Diabetes is the fifth-deadliest disease, and it has no cure. Women with diabetes have an increased risk of vaginal infections and complications during pregnancy. For women who do not currently have diabetes, pregnancy brings the risk of gestational diabetes. Gestational diabetes develops in 2% to 5% of all pregnancies but disappears when a pregnancy is over. Women who have had gestational diabetes are at an increased risk for developing type 2 diabetes later in life.
Pregnancy demands more insulin in the body than normal because of the increased production of hormones that can lead to insulin resistance. For women with diabetes, excellent blood glucose control before conception and then throughout pregnancy is vital to the health of the baby and the mother.
Diabetes also poses special challenges during pregnancy. Women with diabetes are up to 5 times as likely to develop toxemia (a disorder of unknown cause usually marked by hypertension, protein in the urine, edema, headache, and visual disturbances) and hydramnios (excessive amounts of amniotic fluid) as women without diabetes.
Approximately 2 to 5 percent of all non-diabetic pregnant women develop gestational diabetes, a form of diabetes that occurs only during pregnancy. Approximately 40 percent of women with gestational diabetes who are obese before pregnancy develop type 2 diabetes within 4 years. The chance of developing diabetes during this same period is lower if the women are less overweight. Children born of mothers who developed gestational diabetes are more likely to be overweight or obese during adolescence and therefore are at greater risk for diabetes as well.
Between 3 to 5 percent of pregnancies among women with diabetes result in death of the newborn within 28 days. This compares to a rate of 1.5% for women who do not have diabetes. Diabetes during pregnancy (gestational and type 1 diabetes) results in an increased risk for problems such as large birth weight , also called as Macrosomia, birth defects, and other complications for the mother. Macrosomia, occurs 2 to 3 times more often in diabetic pregnancies as in the general population. Because of the increased risk of fetal macrosomia, women with diabetes are 3 to 4 times more likely to have a cesarean section.
The rate of major congenital malformations in babies born to women with pre-existing diabetes varies from 0 to 5 percent among women who receive pre-conception care to 10% among women who do not receive pre-conception care.
Birth control pills can affect blood glucose levels and diabetes control. The intrauterine device (IUD) may lead to infections. Because women with diabetes are already at a higher risk of infection, most should not use the IUD.
What Is Needed?
In ideal circumstances, women with diabetes will have their disease under good control and be monitored frequently by a health care team knowledgeable in the care of diabetes.