‘Diabetes & Women’ was the theme chosen this year by the International Diabetes Federation (IDF) on the occasion of the World Diabetes Day on the 14th November. According to IDF, over 199 million women are currently living with diabetes worldwide. In Mauritius the prevalence of type 2 diabetes amongst women aged 20-74 years was 21.3% compared to men which was 19.6% in 2015 according to the NCD survey of the Ministry of Health. In this article, Dr Noor Abbasakoor, Diabetologist & Endocrinologist and APSA Consultant will talk about gestational diabetes, symptoms of diabetes in Women, Women & Sexuality and prevention.
Symptoms of Diabetes
Both men & women experience the same symptoms & signs of diabetes namely:
- Increased thirst
- Frequent urination
- Feeling more tired than usual
- Unexplained weight loss
- Cuts and wounds taking longer to heal
- Blurred vision
- Mood Swings & nervosity
However, there are symptoms which are unique to women, if they do not control their diabetes:
Vaginal and Oral Yeast Infections and Vaginal Thrush
Diabetes people are more prone to infection due to high sugar levels. An overgrowth of yeast caused by the candida fungus can cause vaginal yeast infections, oral yeast infections, and vaginal thrush.
When the infection develops in the vaginal area, symptoms include itching, soreness, vaginal discharge, rash and painful sex. Oral yeast infections often cause a cottage-cheese coating on the tongue and inside of the mouth.
The risk of a urinary tract infection is higher in women who have diabetes. UTIs develop when bacteria enters the urinary tract. These infections can cause painful urination, a burning sensation, and bloody or cloudy urine. If left untreated, there’s the risk of a kidney infection.
UTIs are common with diabetes due to poor circulation and the inability of white blood cells to work effectively and kill infections.
Female Sexual Dysfunction
Diabetic Neuropathy occurs when high blood Glucose damages nerve fibers. This can trigger tingling and loss of feeling in different parts of the body, including the hands, feet, and legs. This condition may also affect sensation in the vaginal area and lower a woman’s sex drive.
Polycystic Ovary Syndrome
Signs of polycystic Ovary Syndrome include irregular or lack of periods, weight gain, acne, excess hair growth and depression. It can also cause infertility and a type of insulin resistance. This may result in elevated blood sugar levels and increases the risk of developing diabetes.
According to IDF, Gestational Diabetes Mellitus (GDM) is a severe and neglected threat to maternal and child health. 1 in 7 births is affected by gestational diabetes. Many women with GDM experience pregnancy related complications including high blood pressure, large birth weight babies and obstructed labour. A significant number of women with GDM also go on to develop type 2 diabetes.
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnosing diabetes which occurs during pregnancy.
Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. They and their children are also at increased risk of type 2 diabetes in the future.
Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms. If you exercise & have a controlled diet, the risk of developing gestational diabetes is reduced by 30%.
Women , Diabetes & Sexuality
It is fairly well-known that diabetes complications can affect sexuality in men, but it is also true for women. There are many different factors involved in the sexual well-being of women with diabetes and there are many stresses that could interfere with a satisfying experience. Uncontrolled blood sugar levels can lead to complications that affect one’s sex life and cause sexual dysfunctions.
Some of the major problems include:
These are problems that relate to the sexual act itself such as; reduced sex drive, reduced pleasure from sex, lack of vaginal lubrication, lack of pleasurable sensations, reduced ability to experience an orgasm or painful sex. Diabetes may lead to other difficulties such as excessive tiredness, necessity for injections, placement of an insulin pump and/or a continuous glucose monitor, the effects of abnormally high or low blood glucose levels and the time involved in managing diabetes.
Diabetes may lead to psychological effects such as loss of a positive self-image, loss of self-esteem, feelings of unattractiveness: concern about weight gain, negative body image; stress of dealing with a chronic disease: depression, anxiety, worry; or loneliness and isolation. All of these may affect a woman’s sexual well-being. There is some evidence that these problems may be more common in older women with diabetes but, it is not known whether these findings are related directly to diabetes. Those women who require more support as a result of their diabetes may find that this affects their ability to communicate with a partner. Women—younger women in particular—may worry about the effects of diabetes on physical appearance. Weight gain can be associated with insulin therapy. This problem can be eased by adopting healthy eating patterns and by engaging in a physically active lifestyle.
There are numerous treatment modalities like tablets, injections and ampules. However, these can have negative side effects especially on the cardiovascular system. The patient must first consult a doctor for advice before starting any treatment. A patient can also consult a psychotherapist especially under stress and anxiety.
How Can the Burden of Diabetes Be Reduced?
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
- Achieve and maintain a healthy body weight;
- Be physically active – at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control;
- Eat a healthy diet, avoiding sugar and intake of saturated fats; and
- Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular diseases.
A change in diet & exercise can reduce the risk of diabetes by 70%.
Source: WHO, IDF, HealthLine & NCD survey of MOH