Diabetes and Women - Dissertation Example

Running Head: Diabetes And Women Diabetes, no doubt is a very serious public health problem and it has been so for many years. At present a predictable 16 million Americans have diabetes out of which more than half of them are women. Women of all ages are attacked by this killer disease. This paper is an attempt to find out the reasons for the very little progress made towards combating this crippling disease especially in women. This paper also puts forward diabetes across all the ages in women. Introduction Diabetes mellitus (DM) is a developing health care issue in the United States, a course that has deeply touched on the female population. The number of adults having DM augmented by 19% from 1980 to 1996, and are still on the rise. The simultaneous epidemic of corpulence is one of the chief contributors for the rising occurrence of type 2 DM (Hanson, Pettitt, & Bennett et al, 1995) and (Ford, Williamson, & Liu, 1997). The conditions of obesity and diabetes are having an extensive affect on women. During the years 1990 and 1998 there was an increase by 70% of type 2 DM among women aged between 30 and 39 years. At present there are more than 1.85 million women in their reproductive age having type 2 DM. At the same time there are still around 30% cases undiagnosed (Vinicor, 2002). Diabetes in Women Risk factors In the industrialized nations the most general risk components for type 2 DM are obesity which means that their body mass index (BMI) is more than 25 kg/m2, inactive lifestyle, and ingestion of high saturated fat and calories diet. A research among women who were more than 20 years of age showed that they have very little or no physical activity at all (Kriska, LaPorte, Pettitt et.al, 1993). This lack of physical exercise contributes to the dangers of obesity. Actually obesity leads to surplus insulin resistance, thus altering the danger of both glucose intolerance and type 2 DM. Intolerance of Glucose The other risk factors which can be found among women for both type 2 DM and type 1 DM includes family history, unusual fasting glucose forbearance and marred glucose tolerance. The World Health Organization defines Glucose intolerance “as a plasma glucose level between 140 and 200 mg/dL at 2 hours after a 75-g oral dextrose load”. Impaired fasting glucose (IFG) is defined by the American Diabetes Association (ADA) “as a fasting venous plasma glucose level between 110 and 126 mg/dL “(Knowler et.al, 2002). In reality both these findings identified women who are the highest risk of acquiring type 2 DM bearing a cumulative incidence of 29% over 3 years (Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2000). Polycystic ovary condition Women with polycystic ovary syndrome (PCOS) are also among the high-risk group. In the beginning PCOS was the most general kind of female-factor infertility in the US but now it has been discerned as a metabolic disorder too. This metabolic disorder is linked with obesity and insulin resistance (Legro, et. al, 1998; and Hull, 1987). Women between 50% and 80% having PCOS are obese and also women who are lean but with PCOS also tend to be insulin resistant when they are compared with healthy women (Dunaif, et. al 1989). Symptoms The indications for type 1 and type 2 diabetes in most cases are same the only difference being deduction of type 2 diabetes is a bit more difficult than type 1. There may be no indications in some cases of type 2 diabetes or may be the indications may be so mild that they cannot be noticed. Indications can be seen only when the blood glucose level is very high (http://www.acog.org/publications/patient_education/bp142.cfm retrieved 7 December 2009). Disorder X Women who are diagnosed as having PCOS actually constitute a subpopulation that is in the danger zone of being analyzed as having type 2 DM. The symptom is at present termed as the “dysmetabolic syndrome” or “syndrome X.” Women who have syndrome X become resistant towards insulin but are at high risk for coronary thrombosis artery disease, high blood pressure, and type 2 DM (Zavaroni, I, Bonora, E, Pagliara, M, et al.1989). Actually, the dysmetabolic syndrome is at present distinguished as a key independent heart threat agent founded on National Cholesterol Education Program III (NCEP III) rules of thumb (NCEP, 2001). Gestational Diabetes Mellitus GDM GDM is a disorder, which sets hurdles in around 4% of gestations in the United States, (Engelgau, MM, Herman, WH, Smith, PJ, et al. 1988). This disorder is termed as an identifiable risk issue for the subsequent development of type 2 or may be type 1 DM. Women who have the disorder of GDM are at about 17% risk of being diagnosed for DM at 5 years and a 63% risk of getting DM at 16 years after the first gestational diabetic pregnancy (Moses, RG, 1996 and Dornhorst, A, Rossi, M, 1998). Therefore, postnatal psychoanalysis involving weight loss and avoidance are to be undertaken by the disorder possessing women. The ADA advocates that women with GDM should be tested for postgestational Diabetes mellitus DM with a 75-g grape sugar, a 2 hour oral aldohexose acceptance test after 6 weeks of postnatal and once in a 3 year span thereafter (Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2000). Diabetes as a Women’s Health Issue Normally women have to live a complex and challenging life. Same way women who are diabetic also confront the same happiness and problems in their lives but they have to take up an added challenge that is the struggle they have with the chronic disease. They have to face numerous challenges both in the social and personal fronts every hour and every day of their lives. In the year 1985 the Public Health Service Task Force on Women’s Health Issues submitted a report that exhibited health effects faced by women across the life phases and presented some recommendations which in reality motivated elaborated research centering on circumstances and diseases exclusive to or more predominant among women (U.S. Public Health Service, 1985). This report presented certain factors which when applied to a health problem could be termed as a women’s issue. These criteria when applied to diabetes the situation could be very clearly differentiated and it could be ensured as a women’s issue. When diabetes attacks a pregnant woman then it becomes unique as it is a condition which affects both the women and her unborn child (Coustan, 1995 and Buchanan, 1995). Around 2%–5% of all gestations in the United States are perplexed by gestational diabetes. This problem is most general among women of cultural and ethnic groupings at high peril for diabetes. Further more the trouble of diabetes comes unreasonably to women. Actually a range of more than half of all diabetics is women. Apart from this out of 8.1 million women who are diabetic fall in the age group of 20 years or older. In this range grown-up women and minority women are excessively represented (Harris and Kenny et.al 1995). Diabetes leads to a risk for cardiovascular disease and this is more common among women than men. Women who are diabetic in reality lose their premenopausal defense from ischemic heart disease. Apart from this women are at high risk of becoming blind due to diabetes and this count is more than in men (Harris et. all, 1998). Diabetes in women across all the ages The adolescent years Type 1 diabetes which is the primary form of diabetes normally appears in children and adolescents between10 and19 years. This was previously known as insulin-reliant DM. diabetes mellitus. But currently studies have revealed the fact that type 2 diabetes which was previously non-insulin-reliant DM is rising as a public health issue in adolescents. For women adolescence is an age of transition which takes place both physically and psychologically. This may sometimes have a negative effect on those who are already diagnosed as diabetic. Psychological change at an adolescent age might have an impact on the way one puts up with diabetes and how to care for it. At the same time physical change will make it difficult to command diabetes in spite of the degree of observance to the diabetes care schedule (Fagot-Campagna et al., 2000). Reproductive Age which is between 18 and 44 Years Approximately computed women of reproductive age who have diabetes are 1.3 million. And around 500,000 of women in their reproductive age do not know what the deadly disease of diabetes is. In this stage of the life, of a woman, majority of them suffer from type 2 diabetes. Gestational diabetes generally ceases after the birth of the baby. Women who have gestational diabetes have a 20%-50% possibility of acquiring type 2 diabetes in the 5-10 years post childbirth (http:// www.diabetessisters.org/learn-the-facts/women-a-diabetes, accessed December 10, 2009). Pregnancy Hyperglycemia An early detection of hyperglycemia takes place in pregnancy due to either pre-pregnancy diabetes or GDM. The research conducted on hyperglycemia during pregnancy centered chiefly on the wellbeing of the baby. The reason was due to the higher rates of antenatal morbidity; especially when GDM is not cared for or when pre-existent diabetes was not well checked (Metzger, and Coustan, 1998; Kjos and Buchanan, 1999). A diabetic pregnant woman is at greater risk with complications in pregnancy which includes infections, pre eclampsia, and caesarean section. Middle Years that is between 45 and 64 Years Around 3.8 million women between 45 and 64 years are diagnosed as diabetic. Diabetes is one of the leading causes of death amongst the middle aged women. Due to diabetes they suffer from coronary heart disease. During the middle age a large number of women are endangered to foremost chronic diseases like diabetes. While entering into the middle years after the reproductive age women face important changes in their social functions (http:// www.diabetessisters.org/learn-the-facts/women-a-diabetes, accessed December 10, 2009). Women’s health problems during this age crop up due to women’s health issues include the effects of extended contact to genetic and behavioral peril factors developed in adolescence and young age. The particular factors are pre-pregnancy weight, and the weight gained due to gestation and diabetes during the gestational period. Apart from this the low degree of physical activity which continues from young adulthood augments women’s risk of acquiring diabetes in midlife. This is the age when some women go through the decrease in their physical and psychological fitness that may be linked to the menopause (Harris, 1995). The older years between 65 and 74 Diabetic women who are between 65-74 find it very difficult to carry out their day to day tasks. These women actually exhibited a major disability like impairment in actions of the day to day work and physical movement. Also they suffered from urinary incontinence and damages in sight or hearing (Cowie and Eberhardt, 1995). Conclusion The most important objective after being diagnosed as diabetic for any women would be the various treatment options available. Initially stabilization of glucose levels is an important aim. The women patient will work hard to keep her glucose level within the range recommended by her physician with proper diet and physical exercise along with medications if necessary (diabeteshttp://yourtotalhealth.ivillage.com/diabetes-women.html?pageNum=8, accessed 10 December 2009). Insulin therapy may be recommended with type 1 diabetic patient and also for latent autoimmune diabetes of adulthood (LADA). Also women with gestational diabetes may be treated with insulin. Type 2 diabetes can be treated with diet planning and physical activities which may control glucose and decrease weight. Weight loss and increase in physical activity will help in reducing insulin resistance. Physical activity reduces glucose level by absorbing the glucose from blood and making use of it for energy. A well planned diet will help the level of the glucose to stay at a lesser level (diabeteshttp:// yourtotalhealth.ivillage.com/diabetes-women.html?pageNum=8, accessed 10 December 2009). Methods to prevent diabetes in women (diabeteshttp://yourtotalhealth. Ivillage.com/diabetes-women.html?pageNum=8, accessed 10 December 2009). Studies have revealed the fact that changes in lifestyle will either prevent or may delay the attack of type 2 diabetes in women. Some common strategies for prevention of diabetes include: 1. Consumption of a healthy diet, particularly one which consists of less fat and sugar but more of fiber. 2. Maintain a healthy weight by losing surplus weight. 3. Under take regular exercise to decrease glucose level and aid the body to use the insulin. 4. Cholesterol levels to be controlled 5. Blood pressure to be controlled. 6. Losing excess weight and maintaining a healthy weight 7. Exercising regularly, to help lower glucose (blood sugar) levels and help the body use insulin 8. Controlling cholesterol levels 9. Controlling high blood pressure (hypertension) 10. Restricting alcohol intake 11. Quitting smoking References 1. Buchanan TA. 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Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. New England Journal of Medicine. 320 (11), 702-706. Read More