Type 2 Diabetes About 9.7 million women in the United States have diabetes. 

Most women and men diagnosed with diabetes have type 2 

diabetes. Type 2 diabetes used to be called adult-onset diabetes.

But now we know that people can develop type 2 diabetes at any 

age—even during childhood or adolescence. 

The good news is that doctors know a lot about managing 

diabetes. You can lead a long and healthy life with diabetes.

Getting treatment and taking care of yourself can help prevent 

health problems. In fact, your doctor will want you to take an 

active part in your diabetes care. 

What is diabetes? 

Diabetes is a disorder of metabolism— 

the way your body uses digested food for 

growth and energy. Much of the food 

you eat is broken down into glucose, the 

form of sugar in the blood. Glucose is 

the main source of fuel for your body. 

After digestion, glucose enters your 

bloodstream. Then glucose goes to your 

body’s cells to be used for energy. For 

glucose to enter into your cells, insulin 

must be present. Insulin is a hormone 

produced by your pancreas (PAN-kreeuhss), a large gland behind your stomach. 

When you eat, your pancreas automatically produces the right amount of insulin to move glucose from your blood into 

your cells. But if you have type 2 diabeType 2 Diabetes 69 
tes, your body’s system for producing energy doesn’t work correctly. One or both 

of the following things can happen: 

l	 Your cells don’t respond properly to 

your own insulin, a condition called 

insulin resistance. 

l	 Your pancreas makes little or no 

insulin. 

As a result, glucose builds up in your 

blood and passes out of your body in 

your urine. Your body loses its main 

source of fuel, even though your blood 

contains large amounts of glucose. 

You could have type 2 diabetes and not 

know it. In fact, sometimes type 2 diabetes has no warning signs at all. 

l	 Of the 1.3 million women aged 18 to 

44 years with diabetes, one-half million don’t know they have it. 

l	 Of the 4 million women aged 65 years 

and older with diabetes, 1 million don’t 

know they have it. 

Another form of diabetes, type 1 diabetes, formerly called juvenile diabetes or 

insulin-dependent diabetes, is usually 

first diagnosed in children, teenagers,

or young adults. In type 1 diabetes, cells 

in the pancreas no longer make insulin 

because the body’s immune system has 

attacked and destroyed them. People 

with type 1 diabetes must take insulin by 

injection or with an insulin pump. 

Know your risk of type 2 diabetes 

The following factors put you at risk for 

type 2 diabetes. Some of these factors 

are not under your control. But you can 

control a number of the risk factors and 

lower your chances of getting type 2 diabetes. To learn your risk of type 2 diabetes, place a check mark beside each item 

that applies to you. Then show this list to 

your doctor and ask whether you should 

be tested for diabetes. 

Risk factors you can’t control 

❏I am age 45 or older. 

❏My family background is African 

American, American Indian/Alaska 

Native, Hispanic, Asian American, or 

Pacific Islander.* 

❏I have had gestational (jess-TAYshuhn-uhl) diabetes, or I gave birth to 

a baby weighing more than 9 pounds.

(See page 71 for gestational diabetes 

information.) 

❏I have a parent, brother, or sister with 

diabetes. 

❏I have polycystic ovary syndrome, also 

called PCOS. 

❏I have had blood vessel problems affecting my heart, brain, or legs. 

70 The Healthy Woman: A Complete Guide for All Ages 
 

 

 

 

 

 

 

 

 

 

 

 

Risk factors you can control 

❏I am overweight. (See page 22 of the 

Heart Disease chapter for the Body 

Mass Index chart.) 

❏I am fairly inactive. I exercise fewer 

than three times a week. 

❏My blood pressure is 140/90 mmHg 

or higher, or I have been told that I 

have high blood pressure. 

❏My cholesterol (koh-LESS-tur-ol) 

levels are not normal. My HDL 

(good) cholesterol is below 35 mg/dL,

and/or my triglyceride (treye-GLIHsuh-ryd) level is above 250 mg/dL. 

❏I have been told that I have higher 

than normal blood glucose levels, also 

called pre-diabetes, impaired glucose 

tolerance, or impaired fasting glucose. 

❏The skin around my neck or in my 

armpits looks dark, thick, and velvety, a 

skin condition associated with insulin 

resistance called acanthosis nigricans 

(ak-an-THOH-suhss NIG-ruh-kanz). 

❏I have blood vessel problems affecting 

my heart, brain, or legs. 

*If you’re an African American, Hispanic,

American Indian/Alaska Native, Asian 

American, or Pacific Islander woman, you’re 

more than twice as likely as a Caucasian 

woman to get type 2 diabetes. 

What is gestational diabetes? 

Gestational diabetes is a type of diabetes that first develops during pregnancy 

and usually disappears on delivery. It increases the mother’s risk of developing 

diabetes later in life. For more information on how it is diagnosed and treated, 

see the Pregnancy chapter on page 169. 

What is metabolic (met-uhBOL-ihk) syndrome?
 

Metabolic syndrome is a group of 

conditions that increases your risk of 

developing type 2 diabetes, heart disease, or a stroke. If you have any three 

of the following five conditions, you 

have metabolic syndrome, also called 

insulin resistance syndrome: 

• a large waistline: 35 inches or 

more
 

• high triglyceride levels: 150 mg/dL 

or higher 

• low HDL cholesterol levels: below 50 

mg/dL 

• high blood pressure levels: 130/85 

mmHg or higher 

• above-normal fasting blood glucose 

levels: 100 mg/dL or higher 

Preventing or delaying type 2 

diabetes 

A major research study has shown that 

type 2 diabetes can be prevented or delayed in people at high risk of diabetes,

including women with a history of gestational diabetes. People who participated 

in the study 

l	 lowered their intake of fat and calories 

l	 exercised about 30 minutes a day, 5 

days a week 

These efforts resulted in a modest weight 

loss and prevented or delayed diabetes. If 

you are at risk of diabetes, making these 

same lifestyle changes to help prevent or 

delay diabetes is important. 

Type 2 Diabetes 71 
Warning signs of type 2 diabetes 

You might have no warning signs at all.

Or you might have these signs: 

l	 increased thirst 

l	 increased hunger 

l	 fatigue 

l	 increased urination, especially at night 

l	 weight loss 

l	 blurred vision 

l	 sores that don’t heal 

l	 tingling or numb feet or hands 

Diagnosing type 2 diabetes 

Your doctor can use any of the following 

ways to diagnose type 2 diabetes: 

l	 A fasting plasma glucose test measures 

your blood glucose level after you have 

gone at least 8 hours without eating.

Experts recommend this test for 

diagnosis. 

l	 An oral glucose tolerance test measures your blood glucose level after 

you have gone at least 8 hours without 

eating and 2 hours after you drink a 

glucose-containing beverage. 

l	 In a random plasma glucose test, your 

doctor checks your blood glucose level 

at any time of the day without regard 

to when you last ate. Your doctor will 

also ask about signs and symptoms of 

diabetes. 

If the results of any of these tests show 

you have diabetes, your doctor will confirm the results by testing you again on a 

different day. 

Health effects of type 2 diabetes 

Over time, high blood glucose levels 

can lead to serious health problems with 

your eyes, kidneys, nervous system, feet,

skin, teeth, and gums. But the most serious problems, especially for women with 

diabetes, are problems with the heart and 

blood vessels. Such problems can lead to 

heart disease, heart attacks, and strokes.

Diabetes is a more common cause of 

heart disease in women than in men. 

When heart disease occurs in women 

with diabetes, the damage can be worse 

than it is in men with diabetes. The good 

news is that you can prevent or delay 

serious problems by taking care of your 

health. 

Body Parts That Can Be 

Affected by Type 2 Diabetes 

brain 

eyes 

Teeth and 

Gums 

stomach 

kidney 

pancreas 

Digestive 

system 

bladder 

system 

vagina 

Type 2 DIabeTes can aFFecT Many parTs oF your 

boDy, buT you can Do a LoT To Take care oF 

yourseLF anD prevenT HeaLTH probLeMs. 

blood vessels 

Others: 

Feet 

nervous system 

Heart 

skin 

reproductive 

72 The Healthy Woman: A Complete Guide for All Ages 
Fasting* Blood Glucose Numbers (mg/dL) and What They Mean 

Blood glucose numbers What they mean 

From 70 to 99 normal 

From 100 to 125 pre-diabetes, also called impaired fasting 

glucose 

126 and above on more than one test Diabetes 

*note: Fasting means not eating or drinking for at least 8 hours. 

What Women With Type 2 Diabetes Need to Know 

Urinary tract infections • you might have an increased risk of urinary tract infections. (see the Urologic and Kidney Health chapter on page 251.) 

Bladder problems • you might have an increased risk of urinary incontinence. (see the Urologic and Kidney Health chapter on page 251.) 

Fungus or yeast infections • If you are overweight and have high blood glucose levels, you might be at 

increased risk of fungus or yeast infections. These infections can occur in 

the vagina and genital area, under the breasts, or under skin folds. 

Menstrual cycle • changes in your hormone levels before, during, and after your menstrual 

cycle can affect your blood glucose levels. Talk with your doctor about 

how to adjust your medicines and meal plan to keep your blood glucose 

levels on target. 

Birth control • Talk with your doctor about which birth control method would be best for 

you. (see the Reproductive Health chapter on page 153.) 

Sexual dysfunction • you might experience decreased sexual desire, trouble becoming 

aroused or having an orgasm, or pain during intercourse. 

Pregnancy • Meet with your doctor several months before you try to get pregnant. your 

doctor can help you make a plan for getting your blood glucose on target 

before conception. 

• keeping your blood glucose as close to normal as possible before you get 

pregnant and during your pregnancy is the most important thing you can 

do to stay healthy and have a healthy baby. (see the Pregnancy chapter 

on page 169.) 

Breastfeeding • breastfeeding is highly recommended for the babies of women with diabetes. (see the Breastfeeding chapter on page 187.) 

Menopause • as you start to go into menopause, swings in hormone levels can lead to 

swings in blood glucose levels. 

• changes in hormone levels with menopause can lead to lower blood glucose levels. you might need lower doses of your diabetes medicine. (see 

the Healthy Aging chapter on page 221.) 

Type 2 Diabetes 73 
How to prevent or delay heart disease and other health problems 

You can lower your chances of having heart disease and other health problems by 

managing the ABCs of diabetes. 

74 The Healthy Woman: A Complete Guide for All Ages 

Goals for the ABCs of Diabetes 

A is for the A1C blood glucose 

test. The result shows your average 

blood glucose level for the past 2 to 

3 months. 

• aim for lower than 7 percent. 

• your doctor may ask you to aim for lower than 6 percent. 

Ask your doctor what goal is best for you. 

Write your goal here: ________. 

B is for Blood pressure. • aim for lower than 130/80 mmHg. 

C is for Cholesterol. • aim for: 

LDL cholesterol: lower than 100 mg/dL 

HDL cholesterol: higher than 50 mg/dL 

Triglycerides: lower than 150 mg/dL 

Questions to Ask Your Doctor 

About Your A1C Test Result 

• What was the result of my latest 

a1c test? 

• What does the result mean in 

terms of my risk of long-term health 

problems? 

• What can I do to lower my risk of 

long-term health problems? 

Managing diabetes 

Taking care of diabetes requires a team 

approach involving you, your doctor, a 

diabetes educator, a nurse, a dietitian,

other health care providers, and other 

specialists as needed. You are an important part of the team because you will be 

making the decisions about your food,

physical activity, and other important 

parts of your daily diabetes care. 
Treatments for Type 2 Diabetes 

Meal • ask for a personalized meal plan, tailored to your daily routine, from a registered dietitian. 

planning • your dietitian can show you how to include your favorite foods in your meal plan. 

• choosing sensible serving sizes will help keep your blood glucose levels on target. 

• If you want to lose weight, your dietitian can design a meal plan to help you reach your goal. 

• If you choose to drink alcoholic beverages, talk with your doctor about personalized guidelines. In general, most women with diabetes should limit themselves to one drink a day or 

less. 

Physical • before you start an exercise program, ask your doctor what kinds of physical activity would 

activity be best for you. 

• Moderate aerobic physical activity, at least 3 days a week, can help you reach your target 

blood glucose levels and your body weight goal, and lower your risk of heart and blood vessel disease. 

• resistance exercise, three times a week, is also recommended for women with type 2 

diabetes. 

Medicines • 

• 

• 

• 

There are three types of diabetes medicines: pills, insulin (taken by injection or with an insulin pump), and other injectable medicines. 

you might need a combination of medicines to control your blood glucose levels. 

you also might need medicines for other medical conditions, such as high blood pressure 

or high cholesterol. Talk with your doctor about birth control methods. 

ask your doctor whether you should take aspirin every day to prevent a heart attack or a 

stroke. 

All about your blood glucose levels 

Keeping blood glucose levels on target 

day to day will help you feel better and 

help delay or prevent long-term health 

problems. You can check your own blood 

glucose levels using a blood glucose meter. Your doctor or diabetes educator can 

show you how to use a meter. Goals for 

most women are shown below. 

Blood Glucose Targets for 

Most Women With Diabetes 

When Target levels 

before meals 70 to 130 mg/dL 

1 to 2 hours after Less than 180 

the start of a meal mg/dL 

No one expects you to reach your blood 

glucose targets all the time. But the closer you get to your goals, the more you 

will lower your risk of health problems.

Every step helps. 

Blood glucose levels rise and fall many 

times during the day and night. The 

chart on the next page can help you understand why. Remember—sometimes 

you won’t be able to explain why your 

blood glucose is up or down. 

Type 2 Diabetes 75 
What Factors Make Blood Glucose Levels Rise or Fall? 

Reasons blood glucose 

levels rise 



• eating a meal or a snack 

• eating more food or more carbohydrates than usual 

• being physically inactive 

• Having an infection, surgery, injury, or being ill 

• being under stress 

• Having changes in hormone levels, such as during certain times in your 

menstrual cycle 

• Taking certain medicines (side effects) 

• Taking too little diabetes medicine or not taking your diabetes medicine 

Reasons blood glucose 

levels f



all 

• Missing or delaying a meal or a snack 

• eating less food or fewer carbohydrates than usual 

• being physically active 

• Drinking alcoholic beverages, especially on an empty stomach 

• Having changes in hormone levels, such as during menopause 

• Taking certain medicines (side effects) 

• Taking too much diabetes medicine 

Low blood glucose 

Low blood glucose, also called hypoglycemia (heye-poh-gleye-SEE-mee-uh),

happens when your blood glucose is too 

low to provide enough energy for your 

body’s activities. Low blood glucose can 

make you feel shaky, nervous, sweaty,

dizzy, or confused. 

Low blood glucose can occur 

l	 as a side effect of diabetes medicines 

that lower blood glucose levels 

l	 if you miss or delay a meal 

l	 if you eat less than usual 

l	 if you’re more active than usual 

Eating or drinking something with carbohydrates, such as glucose tablets or 

fruit juice, can bring your blood glucose 

level back to normal. Ask your doctor 

how to handle low blood glucose. 

Keeping track of your health 

You and your health care team will work 

together to keep track of your health.

During your office visits, you’ll review 

your blood glucose records, talk about 

your medicines, meal plans, a physical activity routine, and other concerns.

You can use the following reminder list 

of diabetes checkups and discuss other 

things to do to make sure you get the 

best diabetes care. 

76 The Healthy Woman: A Complete Guide for All Ages 
 

 

 

 

Diabetes Checkups 

• A1C test. Have this blood glucose 

test at least twice a year. your result 

will tell you what your average blood 

glucose level was for the past 2 to 3 

months. 

• Blood pressure. Have your blood 

pressure checked every time you 

visit your doctor. 

• Blood fat (lipid) lab tests. Get a 

blood test at least once a year to 

check your cholesterol and other 

blood fats. These test results will 

help you plan how to prevent heart 

disease, heart attack, and stroke. 

• Kidney function tests. Get a urine 

test once a year to check for protein. 

Get a blood test at least once a year 

to measure the amount of creatinine (kree-aT-uh-neen). The results 

of these tests will tell you how well 

your kidneys are working. 

• Dilated eye exam. see an eye care 

professional once a year for a complete eye exam. 

• Dental exam. see your dentist twice 

a year for a cleaning and checkup. 

• Foot exam. ask your health care 

provider to check your feet at least 

once a year to make sure your foot 

nerves and your blood circulation 

are ok. 

• Flu shot. Get a flu shot each year. 

• Pneumonia (noo-MOH-nyuh) vaccine. Get a pneumonia vaccination. 

If you’re older than 64 and your vaccine was more than 5 years ago, get 

another one. 

Be sure to ask your doctor or diabetes 

educator if you have questions about 

what to do during these special times: 

When you’re ill. Illness can raise blood 

glucose levels. Your doctor may suggest 

you check your blood glucose levels more 

often at these times. Ask your doctor for 

other special instructions about taking 

your diabetes medicines when you’re ill. 

When you travel. When you travel, always carry the following with you: 

l	 your diabetes medicines 

l	 your diabetes supplies for checking 

your blood glucose 

l	 food for snacks, a meal, and for treating low blood glucose 

Never put your diabetes medicines or 

supplies in your checked baggage. 

When you change time zones. If you’ll 

be changing time zones, meet with your 

doctor or diabetes educator several weeks 

ahead of time to learn how to adjust your 

diabetes medicines, especially if you take 

insulin. 

Type 2 Diabetes 77 
 

When you take a long car trip. If you 

take diabetes medicines that can cause 

low blood glucose, check your blood 

glucose before you drive to make sure 

it’s in the normal range. Stop and check 

your blood glucose every 2 hours. If your 

blood glucose is low, eat or drink something. Low blood glucose can be dangerous when you’re driving because you can 

pass out. 

Diabetes and your emotions 

Sometimes having a chronic disease like 

type 2 diabetes leads to emotional upset. You might feel angry, afraid, guilty,

or overwhelmed. It’s normal to feel 

this way. Perhaps you’re the one in your 

family who takes care of everyone else.

Maybe you worry about how you’ll have 

time to take care of yourself. 

Depression, a serious medical condition that’s more than feeling sad (see the 

Mental Health chapter on page 207), is 

common in women with diabetes. Depression can get in the way of taking care 

of yourself. If you’re depressed, talk with 

your doctor. Treatment can help. 

You can learn how to cope with having 

diabetes, manage stress, and find support.

Share your concerns with your doctor. 

Some women enjoy going to support 

groups where they can talk with others 

who have diabetes. Or you can get help 

from family and friends. 

Paying for Diabetes Care 

If you’re worried about the cost of your 

diabetes care and need financial assistance, ask your doctor for help in 

finding resources. Medicare helps pay 

for diabetes equipment, supplies, and 

other services. call (800) MeDIcare 

for more information. 

Living well with type 2 diabetes 

You can learn how to live a full and active life with diabetes. Taking care of 

yourself can help delay or prevent diabetes-related health problems. Your health 

care team can provide care and guidance 

during all of the stages of your life. n

78 The Healthy Woman: A Complete Guide for All Ages 
one Woman’s story 

I called my mom, 

who also has type

2 diabetes, and 

she was a great 

help to me. 

I

n 2007, I was on top of the world for a change with respect to my health. With a new 

focus on health once I hit age 40 and knowledge of my family history of high blood 

pressure, cancer, and diabetes, I knew I needed to make some life changes. I didn’t want 

to struggle with those same health problems. I paid attention to what I was eating and 

was physically active four to five times a week. I was even able to stop taking my blood 

pressure medicine. I thought things were going great. 

Then at my annual physical, the doctor 

ran some blood tests and scheduled me 

to come back in a few days. I went back, 

expecting to get an all-clear. The last thing I 

expected to hear was that I now have 

type 2 diabetes. I was in complete shock! 

I said to the doctor, “What? That can’t be 

right. I’ve been doing all the right things.” 

I went into shutdown mode mentally. The 

words just kept echoing in my head. The 

doctor kept talking as if this was not a 

life-changing statement, and there was no 

sense of concern on her part. I was given 

a monitor and told I could use it or not and 

wasn’t given very much more information 

except to stay away from potatoes, rice, and 

starches. she never mentioned working 

with a dietitian, following a healthy lifestyle 

regimen, or finding support groups. I left the office feeling like I had been punched in the 

stomach. I called my mom, who also has type 2 diabetes, and she was a great help to 

me. she told me to get on the Internet and seek out support groups in my area that would 

be able to help me navigate life with diabetes. 

I am fortunate that I am able to control my diabetes with a personalized eating plan and 

physical activity. I do not have to take insulin at this point. It has been a long journey, but I 

am moving through this transition in a positive direction with a positive outlook. and I am 

taking much-needed steps to find a new doctor to help me continue to control my diabetes—someone who can inform me and support me in my efforts. 

Sandra

Las Vegas, Nevada 

Type 2 Diabetes 79 
For More Information... 

Office on Women’s Health, HHS 

200 Independence ave sW, room 712e
 

Washington, Dc 20201
 

Web site: www.womenshealth.gov/faq/
 

diabetes.htm
 

phone number: (800) 994-9662, 
 

(888) 220-5446 TDD 

Division of Diabetes Translation, CDC 

4770 buford Highway ne, Ms k-10
 

atlanta, Ga 30341-3717
 

Web site: www.cdc.gov/diabetes
 

phone number: (800) 232-4636, 
 

(888) 232-6348 TTy 

National Diabetes Education Program, 

NIH 

1 Diabetes Way
 

bethesda, MD 20814–9692
 

Web site: www.ndep.nih.gov
 

phone number: (888) 693-6337
 

National Diabetes Information 

Clearinghouse, NIH 

1 Information Way
 

bethesda, MD 20892-3560
 

Web site: www.diabetes.niddk.nih.gov
 

phone number: (800) 860-8747
 

Office of Women’s Health, FDA 

5600 Fishers Ln
 

rockville, MD 20857
 

Web site: www.fda.gov/womens
 

www.fda.gov/womens/taketimetocare/
 

diabetes
 

phone number: (888) 463-6332
 

American Association of Diabetes 

Educators 

200 W Madison st, suite 800
 

chicago, IL 60606
 

Web site: www.diabeteseducator.org
 

Phone number: (800) 832-6874 to find a 

diabetes educator 

American Diabetes Association 

1701 n beauregard st
 

alexandria, va 22311
 

Web site: www.diabetes.org
 

phone number: (800) 342-2383
 

American Dietetic Association 

120 s riverside plaza, suite 2000
 

chicago, IL 60606–6995
 

Web site: www.eatright.org
 

phone number: (800) 877-1600 ext.5000
 

80 The Healthy Woman: A Complete Guide for All Ages