What Women Need to Know About Diabetes and Heart Disease
By Rita Carey Rubin, Registered Dietitian and Certified Diabetes Educator, Yavapai Regional Medical Center
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 women have against heart 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 heart health.
Women & Undiagnosed Diabetes
Both type 1 and type 2 diabetes increase the risk of a number of health concerns in men and women, including heart disease, kidney disease, and neuropathy (nerve damage). The longer someone has diabetes – especially with poor blood sugar control – the greater the risk of complications. Similarly, the longer someone has prediabetes, when blood sugar levels are above normal, but not yet in diabetes range, the greater the risk of cardiovascular disease.
Research suggests that more than 90 percent 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. Additionally, men and women can have elevated blood sugar or insulin levels (a sign of impaired blood sugar tolerance) for up to 20 years before they are actually diagnosed with diabetes. On top of that, women are often diagnosed with diabetes at a later stage than men.
Women and Heart Attack
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, women and girls are more susceptible to the cellular and vascular damage caused by elevated blood sugar and low-grade inflammation, a chronic side effect of diabetes.
Women may also not respond as well to medical treatment for heart disease. For example, data suggest that some medications, including those used to reduce blood clotting, may not be as effective in preventing heart attacks in women as compared with men. This may be due to 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 partially be due to the fact that women are typically diagnosed with heart disease at an older age, but other factors may also come into play. For example, one study suggests that the blood levels of a particular heart muscle protein – which 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.
Women & the Symptoms of Heart Attack
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 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.
What Puts You at Risk?
Considering all of the risks of cardiovascular disease for women with diabetes, researchers encourage women and their healthcare providers to take extra care catching prediabetes, diabetes and signs of heart disease at their earliest possible stages. Women at risk for prediabetes, diabetes and heart disease include those who:
- Currently have or have had gestational diabetes
- Smoke
- 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 heart disease
Some symptoms of diabetes or prediabetes include:
- Fatigue
- 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 Yavapai Regional Medical Center’s (YRMC’s) Pendleton Center. Excellent classes and individualized counseling sessions are available for people with prediabetes and diabetes. The Pendleton Center also has an adult fitness program, featuring a complete gym and 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.