Expert-reviewed by Ashwini S.Kanade, Registered Dietician and Certified Diabetes Educator with 17 years of experience
Fact-checked by Aditya Nar, B.Pharm, MSc. Public Health and Health Economics
It has time and again been proved that diabetes often strikes women differently when compared to men . This is mainly because of the hormonal variations and inflammation differentiation between the two genders.
Keeping in mind that type 2 diabetes is a chronic low-grade inflammatory disease, its signs, symptoms, and disease progression in women have significantly varied from men.
Some signs and symptoms are unique to women with diabetes:
According to Dr. Vaishali Pathak, Diabetologist at Sahyadri Hospitals, Pune, there are four diabetes-related symptoms and complications which are unique to women:
- Polycystic ovary syndrome (PCOS): Most often, women have diabetes because of PCOS, making them more prone to insulin resistance. In fact, it also the top-most cause of infertility and obesity in women. Its symptoms include hair thinning, acne and excess growth of hair all over the body.
- Urinary tract infections (UTIs): Urinary tract infections in women with diabetes are more severe due to high blood sugar levels and a short urethra. It is one of the most common symptoms of diabetes as the sugar present in the urine presents a breeding ground for the growth of bacteria.
- Vaginal or oral yeast infection: Women with diabetes, especially those with uncontrolled sugar levels, are also more prone to vaginal yeast and fungal infections. Symptoms of vaginal yeast can be itching, pain and uncomfortable vaginal discharge.
- Vaginal dryness or reduced sexual drive: This can also lead to problems with sexual functions, making women with diabetes more prone to decrease in sexual response, blood flow problems and nerve damage (diabetic neuropathy) in some unfortunate cases.
Understanding Gestational diabetes:
Presentation of diabetes during pregnancy is called gestational diabetes mellitus.
Fasting blood sugar (FBS) level >90 mg % and postprandial (post-meal or PPBS) blood sugar level more than 140 mg/dL are the criteria to diagnose diabetes in pregnancy. Usually, around the 24th week of pregnancy, many women develop diabetes with around 18% showing the prevalence of gestational diabetes. 
Obese women, women with a family history of diabetes, and women who have had gestational diabetes in a previous pregnancy are at higher risk than other women for developing gestational diabetes. In fact, women who have had gestational diabetes in the past have 20% to 50% increased chances of developing type 2 diabetes further ahead in their life. 
It is highly recommended that every pregnant woman should undergo oral glucose tolerance tests to diagnose gestational diabetes. A proper diet, exercise and medication can keep gestational diabetes under control.
Pregnancy and diabetes:
If any woman has diabetes, she must take special precautions to undergo pregnancy. The first thing she would have to do is control her blood sugar levels before conception so that her baby will not have any developmental issues. Throughout the pregnancy, she would also need to follow a proper diet and exercise regimen to control her blood sugar levels. Regular visits and follow-up sessions with a diabetologist to take insulin or tablets to keep sugar levels well under control is a must.
If blood sugar levels of any pregnant woman are high during pregnancy, her baby can be affected in the following ways –
- Macrosomia – baby born with a larger than average head
- Heavyweight baby
- Congenital anomalies at birth like cardiac defects
- Babies born to diabetic mothers are likely to have diabetes in future. Not only this, children born to women with gestational diabetes more likely to develop intellectual disabilities later in life. 
- The sudden death of a baby before birth, i.e. stillbirth.
“Type 1 or Type 2 diabetes can affect pregnancy equally if sugar levels are not kept under control, e.g., fasting blood sugar level of more than 90 and postprandial blood sugar of more than 140,” according to Dr. Pathak.
Read how to prevent diabetes-related infertility.
Women with Type 1 diabetes have a higher mortality rate and twice the risk of complications:
While diabetes can affect anyone irrespective of their age, gender, race or lifestyle; research shows that there are differences of sex in the mortality rate associated with type 1 diabetes.
Data from 26 studies revealed that women with type 1 diabetes have a roughly 40% higher and excessive risk of all-cause mortality. Not only this, but they also have twice the chance of fatal and nonfatal vascular events, when compared with men who have type 1 diabetes. 
In fact, according to another study , the death rate for women with diabetes showed no signs of improvement, whereas the death rate for men fell drastically over the past few years. The study found that the most significant reasons for gender differences as far as diabetes is concerned are as follows:
- Diabetes and its related complications in women are more difficult to diagnose when compared to men.
- The way in which hormones and inflammation act in women is entirely different.
- Women tend to have unique and standalone symptoms of diabetes.
- Even heart diseases in women can be different to men.
- Men, when compared to women, tend to receive more aggressive treatment for diabetes and risk factors for cardiovascular disease.
According to Dr, Pathak, “Women in India tend to have a high mortality rate and twice the risk of complications due to the high-fat content of the body in comparison to men. Negligence towards one’s health, poor compliance towards diet and taking medicines without making any lifestyle changes are some of the factors that increase the risk factors with women.”
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- Enza Gucciardi, Shirley Chi-Tyan, Margaret DeMelo, Lina Amaral, and Donna E. Stewart. Characteristics of men and women with diabetes; Observations during patients’ initial visit to a diabetes education centre. Official Publication for the College of Family Physicians of Canada. February 2008. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278314/
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- Edward W. Gregg, Qiuping Gu, Yiling J. Cheng, K. M. Venkat Narayan, Catherine C. Cowie. Mortality Trends in Men and Women with Diabetes, 1971 to 2000. Annals of Internal Medicine Logo. Available at – http://annals.org/aim/article/735918/mortality-trends-men-women-diabetes-1971-2000