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Diabetes and women

Special concerns if you’re a woman with type 2 diabetes
By
WebMD Feature
Medically Reviewed by Dr Rob Hicks

Everyone living with type 2 diabetes will be made aware of the risks and complications that the condition may bring, but women may have special concerns to deal with.

Many of the challenges linked to diabetes in women are hormone related. Hormones can have an effect on blood sugar and at certain times of life - such as during pregnancy or menopause - women need to be aware of changes and the need to keep on top of controlling their blood sugar levels.

Preconception

In an ideal world, women with type 2 diabetes should plan their pregnancy and make sure their blood sugar levels are well controlled before getting pregnant.

"Preconception should be discussed as early as possible, as being pregnant can affect blood glucose levels because of the extremes of hormones in the body," says Pav Kalsi senior clinical advisor at Diabetes UK.

"Women with type 2 diabetes are prescribed a higher than normal folic acid supplement," says Pav. "Instead of the 400 micrograms that is recommended for most women they would be prescribed a higher dose of 5 milligrams of folic acid as there is a higher risk of neural tube defects."

Pregnancy

Throughout your pregnancy you'll have more regular tests and see your specialist team more often. You may have to test your own blood sugar levels a lot more often too.

"Tweaks in your medications may be needed, be it insulin or tablets, as some tablets aren't suitable for pregnant women," says Pav. "High glucose levels can cause the baby to have a higher insulin level and be larger, which can mean a harder birth and perhaps an induced birth."

Breastfeeding can lead to a reduction in blood sugar levels, so your medications will need to be adjusted after you've had the baby.

Gestational diabetes

Gestational diabetes is specific diabetes that only happens when you are pregnant. It occurs in about 3% to 5% of pregnancies.

"If you are overweight, of a certain ethnic background like black or south Asian, or have a family history of diabetes, it's more likely to develop," says Pav.

"Gestational diabetes goes away after you've had the baby, but having it increases your chances of developing type 2 diabetes later in life," Pav adds.

If you develop gestational diabetes your symptoms will be the same as other forms of diabetes, but may not be as obvious. You'll be given extra tests and medications to keep your glucose levels within a tight range.

Menopause

The menopause can be a time when you have to be vigilant about testing your blood sugar because of a loss of the hormone oestrogen.

"Hormones can trigger changes to blood glucose levels," says Pav. "A drop in oestrogen that comes with menopause can be hard enough to deal with in itself but it can be more challenging together with type 2 diabetes."

You may gain weight during menopause which has implications for diabetes. You may need more or different medications if you have a higher glucose level. Hot flushes and night sweats that often come with the menopause may lead to sleep loss. "A lack of sleep and inconsistent sleep patterns can affect your blood glucose levels," says Pav.

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