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Diabetes has health effects unique to women

Diabetes still affects more men than women overall, but rates of diabetes are growing faster in women than men. In Canada, diabetes now affects over 1 million women, most of whom have Type 2.

Endocrinologist Dr. Lorraine Lipscombe, director of the Centre for Integrated Diabetes Care at Women’s College Hospital, led a 2007 study looking at diabetes prevalence in Ontario over a 10-year period from 1995 to 2005. The results showed not just an alarming rise in diabetes rates, but also a shift in who was affected. The fastest-growing group of diabetes patients was young women.

“Everybody’s rates went up, it’s just that in young women they seemed to have gone up much more,” Dr. Lipscombe says. “In women under age 49, the rate of diabetes doubled, while in men there wasn’t as big a jump.”

This increasing burden of diabetes in younger women has broader implications for women’s health.

“There are some unique health issues for women,” Dr. Lipscombe says. “Women have the added burden of diabetes affecting their fertility and menstrual health. Now that women are developing the condition at a younger age, they are more likely to have diabetes in their reproductive years.”

Type 2 diabetes increases the risk for polycystic ovary syndrome, which causes absent or irregular periods and can make it more difficult to conceive. When women with diabetes do conceive, diabetes may increase pregnancy risks.

“If they have diabetes when they get pregnant, or if they develop gestational diabetes during pregnancy, they may have a higher rate of pregnancy complications, which can affect both the mother and her baby,” Dr. Lipscombe says, noting that rates of gestational diabetes are also increasing. Gestational diabetes is high blood sugar that develops during pregnancy, which often resolves after giving birth. However, gestational diabetes increases the risk of developing Type 2 diabetes later in life.

Diabetes is also linked to increased risks of breast cancer and endometrial cancer, in addition to colon cancer.

“Those are the three cancers that are most consistently linked to diabetes,” Dr. Lipscombe explains, noting that breast and endometrial cancers are some of the most common cancers in women, and colon cancer is common in both men and women. “So women have the added burden of having higher risk for three common types of cancer.”

Diabetes is recognized as a major risk factor for heart disease for both men and women, but the impact of diabetes on women’s heart health appears to be greater than on men’s. In all populations, including populations with diabetes, women have a lower rate of heart attacks than men. However, when a woman gets diabetes, it narrows that gender gap: relative to women who don’t have diabetes, her risk is greatly increased. In comparison, when a man gets diabetes, it does increase his cardiovascular risk compared to men without diabetes, but not to the same extent as it would for a woman.

“If you compare cardiovascular events in women who have diabetes versus women who don’t have diabetes, the spread is greater than it is between men with diabetes and men without diabetes,” Dr. Lipscombe explains. “Diabetes appears to be a stronger risk factor for cardiovascular events in women than in men.”

Other differences in how women and men experience diabetes may be related to other health issues. The 2010 POWER (Project for an Ontario Women’s health Evidence-based Report) study on diabetes showed that among people with diabetes, women were more likely than men to also have other health conditions. They were also much more likely to have depression, particularly women with lower incomes.

In the lower income group, 16.4 per cent reported moderate to severe depression on the Canadian Community Health Survey, compared to 7.2 per cent of men. Women with depression still greatly outnumbered men in the higher income group, but the numbers were less dramatic: 5.7 per cent of higher income women with diabetes reported depression, compared to 3.5 per cent of men.

The POWER study also showed that women with diabetes are more likely than men to report having limitations on activities of daily living, which include things like bathing, dressing and preparing meals.

Because of these gender differences, diabetes has unique health effects in women.

“These issues underscore some of the gaps for women with diabetes,” Dr. Lipscombe says. “We need to have greater awareness and support for the ways in which women experience a greater burden with diabetes.”

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: May 3, 2016

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