If you are a woman with diabetes, your risk of developing (and dying from) heart disease may be greater than you think. Diabetes seems to erase, or even reverse the protective effect of female gender against cardiovascular disease and heart attack, making women with diabetes significantly more susceptible than men with diabetes. While the reasons for this are not entirely clear, researchers and healthcare providers agree that women with diabetes need more careful prevention, treatment and tracking to protect their cardiovascular health.
Women are Frequently Diagnosed with Diabetes at a More Advanced Stage
Both type 1 and type 2 diabetes increase the risk of a number of health concerns in men and women, including cardiovascular disease, kidney disease, and neuropathy (nerve damage). The longer someone has diabetes, especially with poor glucose control, the greater the risk of complications. Similarly, the longer someone has prediabetes, when glucose levels are above normal, but not yet in diabetes range, the greater the risk of cardiovascular disease. Research suggests that more than 90% of people with prediabetes don’t know they have it and that women tend to have undiagnosed prediabetes for a longer period of time than men. Additional research suggests that men and women can have elevated blood sugar or insulin levels (a sign of impaired glucose tolerance) for up to 20 years before they are actually diagnosed with diabetes, and that women are often diagnosed with diabetes at a later stage than men.
Women Have Different Responses to Disease and Medical Treatment
Diabetes may be more damaging to the vascular system in females than in males, at any age. A study following a group of children and adolescents with well-controlled type 1 diabetes discovered that girls were more likely to have heart abnormalities and other indicators of early cardiovascular disease than boys. Indeed, research indicates that women and girls are more susceptible to the cellular and vascular damage caused by elevated blood glucose and low-grade inflammation, a chronic side effect of diabetes.
Women may also not respond as well to medical treatment for cardiovascular disease. For example, data suggests that some medications, including those used to reduce blood clotting, may not be as effective in preventing heart attacks in women compared with men. Sub-optimal treatment may be a consequence of women historically being under represented in the clinical trials used to determine the effectiveness and proper dosage of drugs.
There may even be disparities in healthcare for women when compared to men. Data indicate that women may be less likely to have their cardiac risk factors assessed by physicians, and are typically not treated as aggressively as men.
Most critically, women with diabetes are more likely to die as the result of a heart attack than men. This could be partially due to the fact that women are typically diagnosed with heart disease at a later and more debilitated age, but other factors may also come into play. For example, research from a Scottish study suggests that the blood levels of troponin, a heart muscle protein, that when detected in the blood signals a heart attack, are often lower in women having a heart attack than men. Consequently, a woman having a heart attack may not receive appropriate emergency treatment. In addition, women may not experience classic heart attack symptoms, including pain in the chest, arms, back and jaw, heartburn and shortness of breath. The most common symptom of heart attack women may experience is unusual fatigue. In fact, in one study, women reported deep fatigue and disturbed sleep as much as a month or two before a heart attack. During a heart attack, only about one in eight women report chest pain, and tend to describe it as pressure, aching, or tightness rather than pain.
Know Your Risks of Prediabetes, Diabetes and Cardiovascular Disease
Considering all of the risks of cardiovascular disease for women with diabetes, researchers encourage women and their healthcare providers to take extra care and precautions; catching prediabetes, diabetes and signs of cardiovascular disease at their earliest possible stages. Women at risk for prediabetes, diabetes and cardiovascular disease include those who:
- Currently have or have had gestational diabetes
- Are inactive
- Carry extra abdominal fat
- Have polycystic ovarian syndrome (PCOS)
- Experience chronic stress
- Eat a poor diet
- Have periodontal disease
- Have a family history of diabetes and cardiovascular disease
Some symptoms of diabetes or prediabetes are:
- Depression and mood changes
- Increased cravings for sweets
- Sudden weight gain or weight loss
- Chronic vaginal yeast infections
- Chronic urinary tract infections
- Increased hunger, thirst and urination
- Sexual dysfunction
If you have prediabetes or diabetes, check out the services and resources offered at the YRMC Pendleton Center. The Pendleton Center offers excellent classes and individualized counseling for people with prediabetes and diabetes and also has an adult fitness program, featuring a complete gym and large variety of exercise classes designed for people at all levels of fitness, flexibility and strength. Our education and fitness programs are designed to help anyone achieve good blood sugar control and improved fitness, which reduces the risk of cardiovascular disease. For more information, call 928-771-5794.