Everything you need to know about diabetes in women

Warning signs of diabetes | Diabetes symptoms in women | Pregnancy | Breastfeeding | Menopause | Risk factors in women | Treatments

Diabetes is caused by high blood glucose, or blood sugar, which occurs when the body doesn’t make or properly use insulin. Insulin helps sugars from food get into your cells and give you energy. When you don’t have enough insulin or can’t use it properly, glucose builds up in your blood, leading to prediabetes and then diabetes. Both of these conditions increase your risk for heart disease, stroke, blindness, and kidney failure.

In the United States, approximately 34.2 million people—more than 10% of the population—have diabetes. Approximately 15 million women have diabetes.

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Although men are more likely to develop Type 2 diabetes (according to the Centers for Disease Control and Prevention), women are more likely to experience complications from the disease, such as diabetic ketoacidosis, according to a 2016 study.

Warning signs of diabetes

Type 1 diabetes warning signs seem to start overnight. It is an autoimmune disorder where your immune system attacks insulin-producing cells. Early signs include nausea, vomiting, or stomach pains, according to the Mayo Clinic. If you have these symptoms, seek out medical evaluation urgently.

Type 2 develops over years. In the early stages, symptoms of Type 2 diabetes are usually so mild that you don’t notice them. You might not know you have diabetes until results of a routine blood test show elevated blood sugars or a related health condition develops, such as blurred vision or heart disease. 

The warning signs of diabetes—which both men and women should watch for—include:

• Excessive thirst and dry mouth
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Fatigue
• Irritability
• Blurred vision
• Sores taking a long time to heal
• Tingling or numbness in hands and feet
• Frequent infections
• Ketones in urine
• Fruity or sweet-smelling breath
• Dry itchy skin or frequent skin infections

Diabetes symptoms in women

Many diabetes symptoms in women are the same as in men; however, some are unique or more common in women. Women are at increased risk of these types of conditions with either Type 1 or Type 2 diabetes.

Yeast infections

Both vaginal and oral yeast infections can be a result of diabetes. The overgrowth of yeast is caused by candida fungus. The symptoms of vaginal yeast infections include itching, pain, discharge, and pain during sex. The symptoms of oral yeast infections, also called thrush, include white patches in the mouth, difficulty eating or swallowing, and swollen gums or inner cheeks.

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Urinary tract infections

Urinary tract infections, commonly referred to as UTIs, occur because bacteria has entered the urinary tract, including the urethra, ureters, kidneys, and bladder. The presence of sugar in the urine creates an environment where bacteria quickly grow. Symptoms include pain or burning while urinating, frequent or urgent need to urinate, fever, decreased urine flow, lower abdominal cramps, and blood in the urine.

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Decrease in sexual desire

Some women with diabetes experience decreased sexual desire, possibly caused by reduced blood flow to the genital area. Another possible cause is diabetic neuropathy, which is nerve damage resulting in vaginal dryness and discomfort during sex. Diabetes can lead to sexual dysfunction in men as well, both by decreasing desire and causing erectile dysfunction ED is common after years of elevated blood sugars and resultant blood vessel damage.

Diabetes during pregnancy

“It is important for women living with diabetes to plan for pregnancy to prevent potential complications,” says Angela Ginn-Meadow, RN, a registered dietitian and certified diabetes educator based in Baltimore, Maryland. “Uncontrolled diabetes can be dangerous in pregnancy, putting the mother and baby at increased risk of complications.” 

Complications of diabetes during pregnancy include fetal birth defects if the mother’s blood sugar is uncontrolled at the time of conception and during the first trimester, miscarriage if there’s high maternal blood sugar in the first trimester, and large fetal birth size. Maternal uncontrolled diabetes also causes increased circulating insulin in the newborn, which causes low blood sugar in the baby the first few days of life.

It’s also important to talk with your healthcare provider prior to pregnancy because some women with Type 2 diabetes find it more challenging to get pregnant, according to the CDC. 

Prediabetes during pregnancy

Diabetes that develops during pregnancy is called gestational diabetes. About 6% of women who give birth have gestational diabetes. It is caused by a combination of genetic and lifestyle factors, which include:

• Women who are overweight or who gain a lot of weight during pregnancy
• Hormones produced by the placenta can contribute to insulin resistance
• Women with a family history of diabetes
• Some diseases including cystic fibrosis, Cushing’s syndrome, hyperthyroidism, and pancreatitis
• Certain medications, such as niacin, anti-seizure medicines, psychiatric drugs, pentamidine, glucocorticoids, and anti-rejection medications

Gestational diabetes increases the risk of complications during pregnancy, including preeclampsia, miscarriage, premature birth, congenital disabilities, and stillbirth. Babies born to mothers with diabetes are more likely to have macrosomia, large birth weight, and may necessitate a C-section. 

Once the baby is born, gestational diabetes typically goes away—but that doesn’t mean women are out of the woods. “There is a 50% chance of pregnant women with gestational diabetes developing into Type 2 diabetes,” explains Ginn-Meadow. Women who experienced gestational diabetes should be checked for diabetes four to 12 weeks after birth and then regularly. Women with gestational diabetes are encouraged to lose all of their pregnancy weight, as even holding onto 5 to 10 pounds between or after babies significantly increases their risk of converting to Type 2 diabetes. 

Diabetes and breastfeeding

Breastfeeding is encouraged in women with any form of diabetes. There are many health benefits you and your baby can receive from breastfeeding. 

Babies who are breastfed have a lower risk of developing Type 1 diabetes or becoming overweight later in life, according to the American Diabetes Association. It also lowers the mother’s risk of developing high blood pressure, breast cancer, ovarian cancer, osteoporosis, and arthritis. It might also help you lose weight put on during pregnancy and can help women recover from childbirth faster.

A 2015 study found that women who breastfed exclusively for the first two months of their baby’s life decreased their risk of developing Type 2 diabetes by half. For five months or more, the risk dropped even more. The study concluded that the duration of breastfeeding protects mothers who have gestational diabetes.

Diabetes during menopause

During menopause, the body produces less estrogen and progesterone. Because these hormones affect how cells respond to insulin, blood sugar levels fluctuate more, increasing the risk of developing diabetes.

Menopause can also make it more challenging to manage diabetes:

• Weight gain often necessitates medication dosage adjustment
• Decreased estrogen, with associated vaginal dryness, increases the risk of UTIs and vaginal infections
• Lack of sleep caused by hot flashes and night sweats can trigger blood sugar fluctuations

It’s important to maintain communication with your healthcare provider during this time and take steps to stay as healthy as possible. “Eating healthy, getting active 150 minutes per week, and being aware of signs and symptoms of diabetes is the key to prevention,” says Ginn-Meadows.

Risk factors for diabetes in women

Numerous risk factors increase your chances of developing Type 2 diabetes that are similar in both genders. According to the Mayo Clinic, these include:

• Obesity
• Family history of diabetes
• Sedentary lifestyle
• Being Black, Hispanic, American Indian, and Asian American
• Age over 40 years old
• High blood pressure
• Elevated cholesterol and triglyceride levels

In addition to these risk factors, some are specific to women:

• Personal history of gestational diabetes
• Having given birth to a baby weighing over 9 pounds
• History of polycystic ovary syndrome (PCOS)

Diabetes treatments

“A diabetes or prediabetes diagnosis can be quite overwhelming as you begin to research what changes you need to make to keep your risk low,” says Trista Best, MPH, a registered dietitian in Georgia. “A few simple changes in your diet and physical activity that become part of your long-term lifestyle can make huge improvements in your glucose, A1C, and body weight.”

Some people effectively manage their diabetes through diet (avoiding excess sugar and carbs) and exercise alone. Other people need medication or insulin. If you require insulin injections, there are four types of insulin, according to the American Diabetes Association. They include rapid acting, short-acting, intermediate-acting, and long-acting. 

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Additionally, the following is a list of medications used to treat diabetes and special considerations for women.

The side effects of diabetes medications can also affect women differently than men. According to SingleCare’s diabetes survey, gastrointestinal side effects (upset stomach, gas, diarrhea, nausea, vomiting) and yeast infections were more commonly reported in female respondents than males. Males more frequently had complaints of frequent urination, loss of appetite, and weight loss. Report medication side effects to your healthcare provider. They can find a medication that agrees with you to control your blood sugars, and that also helps you stick to an effective diabetes care plan.