Women - Diabets

Women and Diabetes: Special Concerns.

According to the cholesterol management guidelines issued in May 2001 by the National Cholesterol Education Program, National Heart, Lung, and Blood Institute (NHLBI), diabetes poses as great a risk for having a heart attack in 10 years as heart disease itself and should be managed as aggressively as heart disease. A recent survey showed that most people with diabetes don't know that heart disease and stroke are the major causes of death of people with diabetes. In fact, approximately two-thirds of people with diabetes die from cardiovascular disease and they die younger than women without diabetes.

Women with diabetes have lower levels of high-density lipoproteins (HDL) cholesterol (the good cholesterol) and higher levels of triglycerides, or fats, in the blood. According to the NHLBI's cholesterol management guidelines, elevated LDL cholesterol is a major cause of coronary heart disease and should be treated aggressively. Although low-density lipoproteins (LDL) cholesterol (the type of cholesterol that contributes to plaque buildup in your arteries) levels are not higher in women with diabetes, studies find that reducing LDL levels to less than 100 mg/dL can help prevent heart attacks and strokes in women with diabetes.

High cholesterol is typically treated with specially designed diets low in saturated fat, weight loss, exercise and, if necessary, medication.

Other health issues of concern to women with diabetes include:

• High blood pressure. The ideal blood pressure for those with diabetes is less than 130/80 mm/Hg, according to the American Diabetes Association.
• Urinary tract and vaginal infections. Urinary tract infections and vaginal yeast infections are more common in women with diabetes. The fungi and bacteria that cause these infections thrive in a high-sugar environment and the body's immune system can't fight them as effectively when blood glucose levels are too high.
• Menstrual problems. Irregular menstrual periods are common in women with diabetes, especially if their blood sugar isn't well controlled. Blood sugar levels may rise and insulin needs may increase before a woman's period, and fall once it begins.
• Adverse reactions to hormonal birth control methods. Contraceptives containing hormones (such as birth control pills), IUDs that contain progesterone, and long-lasting progestin implants and injections may alter blood glucose levels. Birth control pills may increase insulin resistance in some women with diabetes. Women with type 2 diabetes may find it harder to manage their blood glucose while taking birth control pills. Although rare in healthy individuals, the risk of complications from birth control pills, such as high blood pressure and stroke, are greater for women with diabetes. However, the American Diabetes Association says most birth control methods are safe for women with diabetes—talk to your health care professional about any potential risks.