The presentation and emergence of diabetes in women as they age creates a unique clinical challenge for both women and their healthcare providers. Around the time of menopause, there are important changes in body composition and insulin sensitivity, which impact both the risk for diabetes mellitus as well as glycemic control in those women with established diabetes. For some, menopause is the time for a first diagnosis of diabetes. For others, with existing diabetes, symptoms may be affected by the use of hormone replacement therapy, a common treatment for menopausal vasomotor symptoms, such as hot flashes.
Diabetes is the most common chronic disease in post-menopausal women and is a predisposing factor for cardiovascular disease, a leading cause of death for mature diabetic women. Women with diabetes are more likely to have a heart attack, and at a younger age, than women without diabetes. They are also at greater risk than men for certain microvascular complications such as diabetic retinopathy.
Are You At Risk for Diabetes?
Who is at risk? Those who are overweight, sedentary, age 45 yrs and older, those with a family history of type 2 diabetes, certain ethnic groups (including African Americans and Hispanics) and women who developed gestational diabetes during pregnancy).
The Burden of Diabetes on Women
Since more than half of persons with diabetes are women, the burden of the disease falls disproportionately on women – with a greater representation by those mid-life and beyond. Although the death rates of men with diabetes dropped in recent decades, those of women with diabetes has increased. With the American Diabetes Association estimating that about 9.3 million women have diabetes and the ongoing projected increase in this population, there is an urgency to improving clinical care and outcomes for women as they age.
This is an enormous public health issue, but with some simple lifestyle changes, many women can change the course of this disease. Pre-diabetes, characterized by higher than normal glucose levels, is a warning sign and offers the most opportune time to make dietary changes, increase exercise and strive for weight loss before full diabetes develops. Recent research suggests that long-term damage is already occurring during the pre-diabetic phase. Unfortunately, about 90% of those with pre-diabetes don’t know they have it and thus proceeded to develop diabetes without warning. Although pre-diabetes is a serious medical condition, it can be treated. Preventing or delaying the onset of diabetes is an important step in health aging and ideally requires a partnership with your healthcare provider, scheduling regular health check-ups (including glucose testing) and the adoption of simple lifestyle and dietary changes.
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Focus on nutritional density and variety in your diet by reducing empty calorie foods and increasing the percentage of your daily diet containing items packed with a wide variety of nutrients. Nutrient-dense foods are those that provide substantial amounts of vitamins and minerals with relatively few calories.
