Encouraging women to take charge of diabetes: about 8.1 million women on the United States have diabetes, and one-third of them don't know it

FDA Consumer, Nov-Dec, 2001 by Michelle Meadows

November is National Diabetes Month, a perfect time to consider that about 2,200 people are diagnosed with diabetes every day, and that close to 800,000 will be diagnosed with the disease this year, according to the American Diabetes Association (ADA). Many people don't even know they have diabetes until they develop a serious complication such as blindness, kidney disease, nerve disease requiring amputation, heart disease, or stroke.

The Food and Drug Administration's Office of Women's Health, the ADA, the National Association of Chain Drug Stores, and 80 other organizations nationwide are planning a campaign that will focus on the early identification and control of diabetes. The campaign, scheduled for next year, will highlight the fact that about 8.1 million women in the United States have diabetes, and one-third of them don't know it.

Diabetes-related brochures, wallet-sized calendars, and recipe cards for nutritious meals will be distributed at grocery stores and pharmacies in 10 cities: Atlanta, Baltimore, Chicago, Dallas, Detroit, Indianapolis, Los Angeles, Miami, New Orleans, and Philadelphia.

Diabetes affects the body's ability to produce or respond to insulin. Insulin is a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: Type 1, usually occurring during childhood or adolescence, and Type 2, the most common form of the disease, usually occurring in people older than 45.

A blood test can let you know in minutes whether you have diabetes, and "Get Tested" will be a key message of the campaign. The FDA encourages women to know the factors that put them at high risk for diabetes, including being overweight, being physically inactive, having a brother or sister with the disease, and being African American, Hispanic, Native American, Asian American, or Pacific Islander (see "Take the Risk Test" on this page).

Dezaree Pines-Wilusz, 47, of Bloomfield, Conn., has diabetes and recalls being amazed at reading a list of diabetes risk factors and checking them off one by one. She was overweight, is of African American and American Indian descent, and her father died of complications of diabetes. She also has a history of diabetes on her mother's side of the family.

For Pines-Wilusz, extreme exhaustion was the tip-off that something was wrong. As an insurance agent, she was used to keeping a hectic schedule. But in 1994, she felt like she'd been sapped of all her energy. "I found myself needing to come home in between business appointments or I would have to stop in the middle of vacuuming and rest," she says. Soon after reporting her unusual fatigue to the doctor, a test showed diabetes was the culprit.

Other warning signs of diabetes include frequent urination, unusual thirst, extreme hunger, unusual weight loss, and irritability. Recurring skin, gum, and bladder infections, blurred vision, cuts and bruises that are slow to heal, and tingling or numbness in the hands and feet are also possible symptoms. But often, people with Type 2 diabetes have no symptoms.

Other campaign messages will point out that diabetes is controllable and that women with diabetes should regularly check their blood sugar, that exercise is important, that women should use medicine wisely, and that a healthy diet for people with diabetes isn't so different than a healthy diet for anyone else. For example, lowering fat and cholesterol and eating lots of whole grains and vegetables are sound tips for everyone.

The FDA is also funding ongoing diabetes outreach through the Indian Health Service (IHS). "Portion control is an important message to get out to women in order to impact the escalating diabetes and obesity rates among American Indians and Alaska Natives," says Sandra Dodge, a women's health coordinator with the IHS. The agency is developing culturally-appropriate handouts to help American Indian women with diabetes manage portion sizes for meals. The project will target certain urban areas, as well as American Indian reservations. The overall prevalence of Type 2 diabetes is just over 12 percent in Native Americans versus 5 percent of the general population. In some tribes, half of the population has diabetes.

Diabetes is a unique condition for women. When compared with men, women have a 50 percent greater risk of diabetic coma, a condition brought on by poorly controlled diabetes and lack of insulin. Women with diabetes have heart disease rates similar to men, but more women with diabetes die from a first heart attack than do men with diabetes.

Diabetes also poses special challenges during pregnancy. Compared with women who don't have diabetes, women with diabetes are up to five times more likely to develop toxemia, a disorder marked by hypertension, protein in the urine, swelling, headache, and visual disturbances. Diabetes during pregnancy (gestational diabetes) results in an increased risk for problems such as high birth weight, birth defects, and other complications for the mother. Children born of mothers who developed gestational diabetes are more likely to be overweight or obese during adolescence and therefore are at greater risk for diabetes as well. Women who have had gestational diabetes are at increased risk for developing Type 2 diabetes later.