Diabetes

Diabetes is a disease caused by high levels of blood sugar (glucose) in your body. This can happen when your body does not make insulin or does not use insulin correctly.

Insulin is a hormone made in the pancreas, an organ near your stomach. Insulin helps the glucose from food get into your body's cells for energy. If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood.

Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage.

The three main types of diabetes are:

• Type 1 diabetes. Type 1 diabetes is an autoimmune disease, meaning the body's immune (defense) system attacks and destroys the cells in the pancreas that make insulin. If you have type 1 diabetes, your body does not make insulin, so you must take insulin every day.
• Type 2 diabetes. This is the most common type of diabetes. You can get type 2 diabetes at any age, even during childhood. With type 2 diabetes, your body does not make enough insulin or is not able to use its own insulin correctly. When this happens, blood glucose levels rise.
• Gestational diabetes. Gestational diabetes is a type of diabetes that happens only during pregnancy. Gestational diabetes can cause health problems for the baby and the mother if not controlled. Although gestational diabetes goes away after your baby is born, having diabetes during pregnancy raises your risk for type 2 diabetes later on.² Learn more about gestational diabetes at the National Diabetes Information Clearinghouse.

A risk factor is something that puts you at a higher risk for a disease compared with an average person.

Risk factors for type 1 diabetes in women and girls include:

• Age: It often develops in childhood.
• Family health history: Having a parent or brother or sister with type 1 diabetes
• Certain viral infections or illnesses, such as coxsackie virus B (a common cause of hand, foot, and mouth disease), rotavirus (also called stomach flu), and mumps³
• Where you live: It is more common in people who live in colder climates.

Risk factors for type 2 diabetes in women and girls include:⁴

• Overweight or obesity: Body mass index (BMI) of 25 or higher for adults. Find out your BMI. Children and teens weighing above the 85th percentile based on their BMI are at risk for type 2 diabetes. Find BMI charts for children and teens.
• Older age: 45 or older. After menopause, women are at higher risk for weight gain, especially more weight around the waist, which raises the risk for type 2 diabetes.
• Family health history: Having a mother, father, brother, or sister with diabetes
• Race/ethnicity: Family background of African-American, American Indian/Alaska Native, Hispanic, Asian-American, and Native Hawaiian/Pacific Islander
• Having a baby that weighed 9 pounds or more at birth
• Having diabetes during pregnancy (gestational diabetes)
• High blood pressure: Taking medicine for high blood pressure or having a blood pressure of 140/90 mmHg or higher. (Both numbers are important. If one or both numbers are usually high, you have high blood pressure.)
• High cholesterol: HDL cholesterol of 35 mg/dL or lower and triglycerides of 250 mg/dL or higher
• Lack of physical activity: Women who are active less than three times a week
• Having polycystic ovary syndrome (PCOS)
• Personal history of heart disease or stroke

If you have any of these risk factors, talk to your doctor about ways to lower your risk for diabetes. You can also take the Diabetes Risk Test and talk about the results with your doctor.

Type 1 diabetes usually develops in childhood, but it can happen at any age. It is more common in whites than in other racial or ethnic groups. About 5% of adults with diabetes have type 1 diabetes.¹ Genes you inherit from your parents play an important role in the development of type 1 diabetes. However, where you live may also affect your risk. Type 1 diabetes develops more often in winter and in people who live in colder climates.

Type 2 diabetes is more common in adults, especially in people who are overweight and have a family history of diabetes. About 95% of adults with diabetes have type 2 diabetes.¹ Type 2 diabetes is becoming more common in children and teens as more of them become overweight and obese.⁵

Yes. Certain racial and ethnic groups have a higher risk for type 2 diabetes. These groups include:

• African-Americans. African-American women are twice as likely to develop diabetes as white women.⁶ African-Americans are also more likely to have health problems caused by diabetes and excess weight.
• Hispanics. Hispanic women are twice as likely to develop diabetes as white women.⁶ Diabetes affects more than one in 10 Hispanics. Among Hispanic women, diabetes affects Mexican-Americans and Puerto Ricans most often.¹
• American Indian/Alaskan Native. Diabetes affects nearly 16% of American Indian/Alaskan Native adults.¹
• Native Hawaiian/Pacific Islander. Native Hawaiians/Pacific Islanders are about twice as likely to develop diabetes as whites.⁷
• Asian-Americans. Diabetes is the fifth-leading cause of death for Asian-Americans. Asian-American women are also more likely to develop gestational diabetes than white women and usually develop gestational diabetes at a lower body weight.⁸

Diabetes affects women and men in almost equal numbers. However, diabetes affects women differently than men.

Compared with men with diabetes, women with diabetes have:⁹

• A higher risk for heart disease. Heart disease is the most common complication of diabetes. Learn more about the link between heart disease and stroke and diabetes in women
• Lower survival rates and a poorer quality of life after heart attack
• A higher risk for blindness
• A higher risk for depression. Depression, which affects twice as many women as men, also raises the risk for diabetes in women.¹⁰

Yes. The longer you have type 2 diabetes, the higher your risk for developing serious medical problems from diabetes. Also, if you smoke and have diabetes, you are even more likely to develop serious medical problems from diabetes, compared with people who have diabetes and do not smoke.¹¹

The extra glucose in the blood that leads to diabetes can damage your nerves and blood vessels. Nerve damage from diabetes can lead to pain or a permanent loss of feeling in your hands, feet, and other parts of your body.¹²

Blood vessel damage from diabetes can also lead to:

• Heart disease
• Stroke
• Blindness
• Kidney failure
• Leg or foot amputation
• Hearing loss

Women with diabetes are also at higher risk for:  

• Problems getting pregnant
• Problems during pregnancy, including possible health problems for you and your baby
• Repeated urinary and vaginal infections

Researchers do not know the exact causes of type 1 and type 2 diabetes. Researchers do know that inheriting certain genes from your family can raise your risk for developing diabetes. Obesity is also a major risk factor for type 2 diabetes. Smoking can also cause type 2 diabetes. And the more you smoke the higher your risk for type 2 diabetes and other serious health problems if you already have diabetes.¹³

Weight loss can help control type 2 diabetes so that you are healthier. Quitting smoking can also help you control your blood sugar levels. Being a healthy weight and not smoking can help all women be healthier.

But, obesity and smoking do not always cause diabetes. Some women who are overweight or obese or smoke never develop diabetes. Also, women who are a normal weight or only slightly overweight can develop diabetes if they have other risk factors, such as a family history of diabetes. 

Type 1 diabetes symptoms are usually more severe and may develop suddenly.

Type 2 diabetes may not cause any signs or symptoms at first. Symptoms can develop slowly over time. You may not notice them right away.

Common signs and symptoms of type 1 and type 2 diabetes include:

• Feeling more tired than usual
• Extreme thirst
• Urinating more than usual
• Blurry vision
• Feeling hungrier than usual
• Losing weight without trying
• Sores that are slow to heal
• Dry, itchy skin
• Tingling in the hands or feet
• More infections, such as urinary tract infections and vaginal yeast infections, than usual

Maybe. You should be tested for diabetes if you are between 40 and 70 years old and are overweight or obese. Your doctor may recommend testing earlier than age 40 if you also have other risk factors for diabetes. Also, talk to your doctor about diabetes testing if you have signs or symptoms of diabetes. Your doctor will use a blood test to see if you have diabetes.

If the testing shows that your blood sugar levels are high, you can begin making healthy changes to your eating habits and getting more physical activity to help prevent diabetes.

Prediabetes means your blood sugar (glucose) level is higher than normal, but it is lower than the diabetes range. It also means you are at higher risk of getting type 2 diabetes and heart disease.

As many as 27 million American women have prediabetes.¹⁴ If you have prediabetes, you can make healthy changes, such as doing some type of physical activity on most days, to lower your risk of getting diabetes and return to normal blood sugar levels. Losing 7% of your body weight (or 14 pounds if you weigh 200 pounds) can lower your risk for type 2 diabetes by more than half. If you have prediabetes, get your blood glucose checked every year by a doctor or nurse.¹⁵

Diabetes treatment includes managing your blood sugar levels to control your symptoms. You can help control your blood sugar levels by eating healthy and getting regular physical activity.

With type 1 diabetes, you also will need to take insulin through shots or an insulin pump. Insulin cannot be taken as a pill.

Type 2 diabetes treatment also may include taking medicine to control your blood sugar. Over time, people with type 2 diabetes make less and less of their own insulin. This may mean that you will need to increase your medicines or start taking insulin shots to keep your diabetes in control.

Learn more about controlling diabetes at the National Diabetes Education Program website.

Researchers do not know how to prevent type 1 diabetes. Researchers are still looking for ways to prevent type 1 diabetes in women and girls by studying their close relatives who have diabetes.

Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose.

• Weight loss: Obesity is a leading risk factor for diabetes. Calculate your BMI to see whether you’re at a healthy weight. If you’re overweight or obese, start making small changes to your eating habits and get more physical activity. Even a small amount of weight loss (7%, or about 14 pounds for a 200-pound woman) can delay or even prevent type 2 diabetes.
• Eating healthy: Choose vegetables, whole grains (such as whole wheat or rye bread, whole grain cereal, or brown rice), beans, and fruit. Read food labels to help you choose foods low in saturated fat, trans fat, and sodium. Limit processed foods and sugary foods and drinks.
• Getting active. Aim for 30 minutes of physical activity most days of the week and limit the amount of time you spend sitting.

Learn how to eat healthier and get more physical activity.

Yes. If you have type 1 or type 2 diabetes, you can have a healthy pregnancy. If you have diabetes and you want to have a baby, you need to plan ahead, before you get pregnant.

Talk to your doctor before you get pregnant. He or she can talk to you about steps you can take to keep your baby healthy. This may include a diabetes education program to help you better understand your diabetes and how to control it during pregnancy.

For more information about diabetes, call the OWH Helpline at 800-994-9662 or contact the following organizations:

• National Diabetes Education Program, CDC, HHS 
  Phone Number: 800-232-4636
• National Diabetes Information Clearinghouse, NIDDK, NIH, HHS 
  Phone Number: 800-860-8747
• American Diabetes Association 
  Phone Number: 800-342-2383

1. Centers for Disease Control and Prevention (2014). National Diabetes Statistics Report, 2014. Source of data: 2009–2012 National Health and Nutrition Examination Survey.
2. Coustan, D.R., Ed. (2013). Medical management of pregnancy complicated by diabetes. 5th edition. Alexandria, VA: American Diabetes Association.
3. Filippi, C.M., von Herrath, M.G. (2008). Viral Trigger for Type 1 Diabetes. Diabetes; 57(11): 2863-2871.
4. American Diabetes Association (2013). Standards of medical care in diabetes — 2013. Diabetes Care, 36 (Suppl 1), S11–66.
5. Li, C., Ford, E.S., Zhao, G., Mokdad, A.H. (2009). Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among US adolescents: NHANES 2005–2006. Diabetes Care; 32:342–347.
6. Centers for Disease Control and Prevention (2013). National Diabetes Surveillance System.
7. Centers for Disease Control and Prevention (2012). Summary Health Statistics for U.S. Adults: 2011. Table 8.
8. Blatt, A.J., Nakamoto, J.M., Kaufman, H.W. (2011). Gaps in diabetes screening during pregnancy and postpartum. Obstet Gynecol; 117: 61–68.
9. American Diabetes Association. (n.d.) Depression.
10. Pan, A., et al. (2010). Bidirectional Association Between Depression and Type 2 Diabetes Mellitus in Women.  JAMA Internal Medicine; 170(21): 1884-1891.
11. Eliasson, B. (2003). Cigarette smoking and diabetes. Prog Cardiovasc Dis; 45(5): 405-13.
12. National Institute of Diabetes and Digestive and Kidney Diseases. (2013). Diabetic Neuropathies: The Nerve Damage of Diabetes.
13. U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 537-545.
14. Centers for Disease Control and Prevention (2013). Women at High Risk for Diabetes: Physical Activity, Healthy Eating, and Weight Loss.
15. American Diabetes Association (2013). Standards of medical care in diabetes — 2013. Diabetes Care, 36 (Suppl 1), S11–66.