“Women with diabetes need to be vigilant in working with their health care providers in the treatment of the disease as well as in the prevention of complications from it,” says Fernando Ovalle, M.D., a UAB specialist in endocrinology, diabetes and metabolism.
Diabetes and the Menstrual Cycle
An article, co-authored by Dr. Ovalle, reports that Diabetic Ketoacidosis (DKA), an acute complication of diabetes mellitus which can be life-threatening, is more common in young women than men, and has been associated with the menstrual cycle. The article is to be published in the March 2008 issue of The American Journal of the Medical Sciences.
Diabetes and the Heart
New research from UAB also shows that the effect of diabetes on the severity of illness and risk of death for patients with heart failure is much worse in women than men. The effect is even more pronounced in older patients, according to findings published online in Heart last year.
The UAB research team, led by Ali Ahmed, M.D., MPH, associate professor in the division of gerontology, geriatrics and palliative care and director of UAB’s Geriatric Heart Failure Clinic and Geriatric Heart Failure Research, found that diabetes was associated with a significant increase in the risk of death and hospitalization in patients with heart failure. Women over age 65 had worse outcomes than men or younger women.
An estimated 9.7 million American women have diabetes, and almost one-third of them do not know it. Women with diabetes are more likely to have a heart attack, and at a younger age, than women without diabetes, according to the American Diabetes Association (ADA).
Number of Women at Risk for Diabetes is Increasing Diabetes is at least two to four times more common among African-American, Hispanic, American Indian, and Asian/Pacific Islander women than Caucasian women. The risk for the disease increases with age. Given the increasing life span of women and the rapid growth of minority populations, the number of women in the U. S. at risk for diabetes is increasing, the ADA states.
An Alarming Study
A study in the Annals of Internal Medicine reported that medical advances against diabetes of the last few decades have not benefited women. The findings challenge the conventional wisdom that women live longer than men. Researchers found that the death rates of men with diabetes dropped in recent decades, while those of women with diabetes increased. It is not clear why the discrepancy exists.
Dr. Larry Deeb, spokesperson for ADA, says he really does not know why the study shows women have fallen behind. “But I do know that it argues that something we’re doing isn’t right,” says Dr. Deeb. “If you’re a woman, and you have diabetes, it may be we’re not aggressive enough about taking care of you.”
In the new study, researchers led by Edward Gregg, Ph.D., an epidemiologist with the Centers for Disease Control and Prevention (CDC), examined health surveys spanning 1971 to 2000 to determine the death rates of Americans with diabetes.
Among men, “their mortality rates have declined,” Dr. Gregg say, “and they’ve kept pace with their non-diabetic counterparts.” But among women with diabetes, the death rate actuall rose from 18 to 26 per 1,0000 even as the life span of women without diabetes grew larger. Death rates from cardiovascular disease, in particular, stayed steady among women with diabetes while dropping among men with diabetes.
Why are Women with Diabetes at Such High Risk?
“We can speculate on a few possibilities, that risk factors for things such as heart disease haven’t declined as much among women as in men,” notes Dr. Gregg. “Another possibility is that women haven’t gotten as aggressive or comprehensive treatment as men have over the years,” he says.
New Study Shows Improvement
Meanwhile, a second new study says that women are now about as likely as men to get recommended screening tests and treatments to manage their diabetes. According to the latest statistics from the Agency for Healthcare Research and Quality (AHRQ), for Americans age 40 and over with diabetes:
- The percentage of women who report being given three key recommended exams for diabetes – blood sugar, eye, and foot – increased from 37 percent in 2000 to 47 percent in 2003.
- During the same period, the percentage of men who reported receiving theses exams rose only 3 percent from 46 percent to 49 percent.
- The proportion of women whose blood sugar level was optimal increased from 38 percent for the period 1988 to 1994 to 47 percent for 1999 to 2002.
- In contrast, the proportion of men with optimal blood sugar level fell from 44 percent to 43 percent during the period.
In spite of the narrowing disparities between the genders, fewer than 60 percent of Americans, as a whole, receive optimal care for their diabetes.
UAB offers a Diabetes Prevention Class as well as a Diabetes Self-Management Class. To register, or for more information, please call 801-8711.
American Diabetes Alert® Day
March 25 is the 20th Annual American Diabetes Alert® Day. The American Diabetes Association (ADA) is urging the over 6 million Americans who are unaware they have diabetes or are at risk for developing type 2 diabetes to take the Diabetes Risk Test. At the ADA Diabetes Risk Test site, you can also learn more about your risk for diabetes and its complications by getting your Diabetes PHD (Personal Health Decisions), a free health risk calculator. Additionally, the UAB Diabetes Health Tools page also provides you with illustrated explanations and a quiz you can take to find out how much you know about diabetes.
Information on UAB research about diabetes and heart failure from Bob Shepherd, UAB Media Relations.