Better understanding of women’s hormonal changes may improve diabetes management
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Key takeaways:
- Women have more diabetes risk factors specific to their sex compared with men.
- Women with diabetes also have more to manage due to hormonal changes throughout their lifetime.
HOUSTON — Women’s various hormonal changes throughout their lifetime can make their diabetes management more complex compared with men, according to a presenter at the Association of Diabetes Care and Education Specialists annual meeting.
“As a clinician, I noticed a great gap in management of diabetes in women, and I came to realize the importance of understanding women’s specific risk factors to provide a better client-centered care,” Nazli Parast, RN, CDE, BScN, MScN, EdD, an advanced practice nurse and certified diabetes educator in the women’s heart health and hypertension clinics at the University of Ottawa Heart Institute, told Healio. “I wanted to take this further, so I performed a rapid literature review to assess the need, hoping to do research in this area to help support women, their diabetes management and cardiovascular health.”
According to Parast, simply including women in research studies is insufficient because women present with different challenges at different times in their life — before, during, after pregnancy and menopause — and this includes different changes in diabetes management compared with men.
In an ePoster presented during the Association of Diabetes Care & Education Specialists annual meeting, Parast said, compared with men, women have more diabetes risk factors specific to their gender including more physical inactivity, weight gain from pregnancy and polycystic ovarian syndrome, and the link between obesity and diabetes is stronger in premenopausal women, early menopause and premature ovarian insufficiency. In addition, gestational diabetes increases lifetime risk for type 2 diabetes and independently increases the risk for CVD.
Parast also highlighted that women with diabetes often have more to manage compared with men:
- higher risks for heart disease and other diabetes-related complications;
- higher risk for developing yeast and urinary tract infections;
- difficulty with glycemic management due to hormonal changes before and during menstruation;
- increased pregnancy complication risk with diabetes; and
- unpredictable elevations and drops in glucose due to reductions in estrogen during premenopause and menopause.
“When we better understand the challenges women are going through and pose solutions — whether it is more specific and targeted medication management or lifestyle modification or coaching — we will be able to help them reach the target,” Parast said. “Keep in mind that managing diabetes can have a huge impact on improving cardiovascular health, specifically in women.”
Regarding diabetes and CVD in women, diabetes increases the risk for myocardial infarction by threefold to sevenfold for women compared with twofold to threefold for men. Women with diabetes also have a 58% greater risk for coronary heart disease and a 13% greater risk for all-cause mortality compared with men.
Compared with women without diabetes, those with type 1 diabetes have a fourfold higher risk and those with type 2 diabetes have a twofold higher risk for total stroke. Heart failure risk was also higher among women with diabetes compared with men with diabetes.
“More in-depth research [is needed] on how ... to approach diabetes management in women and try to reduce the risk of cardiovascular disease in women,” Parast said.