Women and Diabetes

Women and Diabetes Fact Sheet

Diabetes currently affects over 246 million people worldwide and over half of these people are women. Already considered an “epidemic,” researchers expect these rates to increase to 380 million by 2025. In the US, almost 21 million children and adults have diabetes — including 9.7 million women — and almost one third of them do not know it. Diabetes can be especially hard on women. The burden of diabetes on women is unique, because the disease can affect both mothers and their unborn children. Diabetes can cause difficulties during pregnancy such as a miscarriage or a baby born with birth defects. Women with diabetes are also more likely to have a heart attack, and at a younger age, than women without diabetes.

Diabetes is the fifth deadliest disease in the United States, and it has no cure. For women who do not currently have diabetes, pregnancy brings the risk of gestational diabetes. Gestational diabetes develops in 2% to 5% of all pregnancies but disappears when a pregnancy is over. Women who have had gestational diabetes or have given birth to a baby weighting more than 9 pounds are at an increased risk for developing type 2 diabetes later in life.

The prevalence of diabetes is at least 2-4 times higher among African American, Hispanic/Latino, American Indian, and Asian/Pacific Islander women than among white women. The risk for diabetes also increases with age. Because of the increasing lifespan of women and the rapid growth of minority populations, the number of women in the United States at high risk for diabetes and its complications is increasing. Because women are often influential in affecting behavior change in their own children and families, focusing prevention efforts on them is a good way to improve not only their health but also the health of those they love.

Diabetes has Unique and Profound Effects on Women

More than 11 million women in the US have diabetes. Women in minority racial and ethnic groups are the hardest hit by type 2 diabetes; the prevalence is two to four times higher among black, Hispanic, American Indian, and Asian-Pacific Islander women than among white women. Because minority populations are expected to grow at a faster rate than the U.S. population as a whole, the number of women in these groups who are diagnosed with diabetes will increase significantly in the coming years. Diabetes is a more common cause of coronary heart disease among women than men. Among people with diabetes, the prognosis of heart disease is worse for women than for men; women have poorer quality of life and lower survival rates than men do. The link between diabetes and obesity is striking. Nearly half (47%) the women with diabetes have a body mass index greater than 30 kg/m2 compared with 25% of all women.

Diabetes Affects Women Differently at Various Life Stages

Adolescent Years (10-17 Years)

About 86,192 females younger than 20 years old have type 1 diabetes; 92% are white, 4% are black, and 4% are Hispanic or Asian American.

Eating disorders may be higher among young women with type 1 diabetes than among young women in the general population. There is an apparent increase in the number of youth of all racial and ethnic groups being diagnosed with type 2 diabetes, and it appears to be more common among girls than boys.

By age 20 years, 40%-60% of people with type 1 diabetes have evidence of retinopathy, or diabetic eye disease. Untreated retinopathy can lead to blindness. The risk for developing proliferative retinopathy—the most severe form—is higher for girls than for boys (in at least one study).

Reproductive Years (18-44 Years)

An estimated 1.3 million women of reproductive age have diabetes; about 500,000 of them do not know they have the disease. Type 2 diabetes accounts for most diabetes cases during this life stage. Most women with type 1 diabetes were diagnosed during childhood or adolescence.

Women of minority racial and ethnic groups are two to four times more likely than non-Hispanic white women to have type 2 diabetes. Reproductive-aged women with type 2 diabetes have fewer years of education, have lower income, and are less likely to be employed than women without diabetes.

Estimates of the overall prevalence of gestational diabetes in the United States range from at least 2.5% to 4% of pregnancies that result in singleton live births, with higher percentages among some ethnic groups and older women. Most gestational diabetes occurs in women with risk factors for type 2 diabetes; they are unable to secrete sufficient insulin to overcome the increased insulin resistance that normally results as pregnancy proceeds.

Gestational diabetes usually ends after the baby is born, but women with gestational diabetes have a 20%-50% chance of developing type 2 diabetes in the 5-10 years after childbirth.

Children whose mothers had diabetes during their pregnancies have a greater likelihood of becoming obese during childhood and adolescence and of developing type 2 diabetes later in life.

Middle Years (45-64 Years)

Approximately 3.8 million women aged 45-64 years have diabetes.

Diabetes is a leading cause of death among middle-aged American women.

Coronary heart disease is an important cause of illness among middle-aged women with diabetes; rates are three to seven times higher among women 45-64 years old with diabetes than among those without diabetes.

In 2000, at least one in four women aged 45-64 years with diabetes had a low level of formal education, and one in three lived in a low-income household. Women with diabetes were more likely than women without diabetes to have a low socioeconomic status regardless of race, ethnicity, or living arrangements (marital status, size of household, and employment status).

Older Years (65 Years and Older)

About 4.0 million women aged 65 years and older have diabetes; one-quarter of them do not know they have the disease. Most elderly women with diabetes have type 2 diabetes.

Because women make up a greater proportion of the elderly population and women with diabetes live longer than their male counterparts, elderly women with diabetes outnumber elderly men with diabetes. Diabetes is one of the leading underlying causes of death among women aged 65 years and older.

Being older and having diabetes accelerate the development of diabetic complications such as heart disease, stroke, kidney disease, and blindness. Elderly women with diabetes are at particularly high risk for coronary heart disease, visual problems, hyperglycemia or hypoglycemia, and depression.

Factors That Place Women at Risk for Diabetes and Its Complications

Women face increasing risk of diabetes and its complications because of certain social, cultural, and economic trends. National surveys have indicated that since the 1970s there are increasing trends in the numbers of women who

• live in poverty (by age 65, women are twice as likely as men to be poor);
• work in small companies that provide fewer benefits and lower pay than larger companies, and face significant challenges to balance job and family responsibilities;
• are uninsured and/or lack access to health care (approximately one in seven women lack health insurance);
• are overweight and do not exercise regularly (about one-half of women aged 20 years or older are overweight, and more than one-quarter do not engage in regular physical activity).

*Statistics compiled from the Centers for Disease Control and the American Diabetes Association