***DIABETES FACTS***

**WOMEN AND DIABETES**

**[What Is Diabetes?]{.underline}**

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 age 45, but is increasingly being diagnosed in
children and adolescents.

**[How Does It Affect Women?]{.underline}**

Approximately **9.1 million or 8.9% of all women in the United States
have diabetes**, however, about a third of them do not know it. The
prevalence of diabetes is at least 2-4 times higher among African
American, Hispanic/Latino, American Indian, and Asian/Pacific Islander
women than among white women. Because of the increasing lifespan of
women and the rapid growth of minority populations, the number of women
in the United States at high risk for diabetes and its complications is
increasing.

Diabetes is the **fifth-deadliest disease** in the United States, 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.

# [Women and Diabetic Complications]{.underline}

-   The risk for **cardiovascular disease**, the most common
    complication attributable to diabetes, is more serious among women
    than men. Deaths from heart disease in women with diabetes have
    increased 23 percent over the past 30 years, compared to a 27
    percent decrease in women without diabetes.

```{=html}
<!-- -->
```
-   The risk of **diabetic ketoacidosis** (DKA) is **50 percent higher
    among women** than men. DKA, often called diabetic coma, is a
    condition brought on by poorly controlled diabetes and marked by
    high blood glucose levels and ketones (by-products of fat metabolism
    in the blood). Although it is accompanied by high blood glucose
    levels, DKA is not caused by high blood sugar; it is caused by lack
    of insulin. Before insulin therapy was available, DKA was the
    predominant cause of death from diabetes.

-   Women with diabetes are **7.6 times as likely** to suffer
    **peripheral vascular disease** (PVD) than women without diabetes.
    PVD is a disorder resulting in reduced flow of blood and oxygen to
    tissues in the feet and legs. The principal symptom of PVD is
    intermittent claudication (pain in the thigh, calf, or buttocks
    during exercise).

**Pregnancy and Diabetes**

-   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.

-   The rate of **major congenital malformations** in babies born to
    women with preexisting diabetes varies from 0 to 5 percent among
    women who receive preconception care to 10% among women who do not
    receive preconception care.

-   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.

-   **Macrosomia**, large birth weight, 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**.

-   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.

**Diabetes and Birth Control**

-   **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?]{.underline}**

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.

-   **Patient education is critical**. People with diabetes, with the
    help of their health care providers, can reduce their risk for
    complications if they are educated about their disease, learn and
    practice the skills necessary to better control their blood glucose
    levels, as well as blood pressure and cholesterol levels, and
    receive regular checkups from their health care team. Smokers should
    stop smoking, and overweight women with diabetes should develop
    moderate exercise regimens under the guidance of a health care
    provider to help them achieve a healthy weight.

-   **Health care team education is vital**. Because people with
    diabetes have a multi-system chronic disease, they are best
    monitored and managed by highly skilled health care professionals
    trained with the latest information on diabetes to help ensure early
    detection and appropriate treatment of the serious complications of
    the disease. A team approach to treating and monitoring the complex
    facets of this systemic disease serves the best interests of the
    patient.

-   **Non-diabetic pregnant women** should be checked for gestational
    diabetes between the 24th and 28th weeks of pregnancy unless they
    are in the low-risk category. This category includes women who are
    less than 25 years of age, have no family history of diabetes, have
    a normal body weight and are not a member of an ethnic/racial group
    with high prevalence of diabetes (i.e., Hispanic/Latino, African
    American, Native American, and Asian).

**For more information, contact the American Diabetes Association at
1-800-DIABETES**

**(1-800-342-2383), or visit our Web site at www.diabetes.org.**

3/02