It's estimated that 15 million American women, or one in nine, have diabetes.¹ Diabetes is a chronic health condition that increases the risk of heart disease — especially in people assigned female at birth, who are four times more likely to develop cardiac issues if they have diabetes.² (Diabetic men or those assigned male at birth are twice as likely.) This increased risk may partially be due to differing treatment plans and increased risk of heart disease factors like obesity, systemic inflammation and high cholesterol in women.³ Women also have a higher risk of diabetes complications like blindness, kidney disease and depression.⁴
What are the types of diabetes?
Diabetes is a chronic health condition that affects how your body turns food into energy. In some cases, your pancreas doesn't make enough insulin (the hormone that helps regulate blood sugar, or blood glucose, levels). In others, the insulin it does produce isn't regulating blood sugar the way it should.
The risks associated with diabetes can often be prevented through lifestyle changes, testing for diabetes at home or consulting your healthcare professional if you have a history of diabetes in your family.
There are three common types of diabetes:
- Type 1 diabetes is an autoimmune disease which causes the immune system to attack insulin-producing cells in the pancreas. If you have type 1 diabetes, you need insulin injections to keep your glucose levels stable. Symptoms of type 1 diabetes can appear suddenly.
- Type 2 diabetes is diagnosed when your body can no longer make enough insulin or cannot use the insulin it produces correctly. As a result, your blood glucose levels rise. Symptoms of type 2 diabetes tend to come on gradually, although sometimes there are no immediate signs.⁵
- Gestational diabetes is a type of diabetes that occurs during pregnancy and goes away after birth. It can cause health problems for mother and baby and increase both their risk of developing type 2 diabetes later on.⁶
What are the signs and symptoms in women with diabetes?
There are many symptoms of diabetes. Here are the symptoms specific to women or people assigned female at birth:
Yeast infections and UTIs
While anyone can get yeast infections or urinary tract infections (UTIs), genitourinary candidiasis (yeast infection of the genital or urinary organs)⁷ is more commonly diagnosed in women.⁸ Diabetic women and those assigned female at birth are at increased risk of this infection because yeast feeds off sugar.⁹ So if you have high blood sugar and your kidneys are no longer able to keep up, the yeast can thrive and cause vaginal yeast infections and vaginal itching.¹⁰
Diabetes can also affect your circulation, making it harder for your body to fight off infection and increasing your risk of UTIs.¹¹ As a result of nerve damage, people with later stage diabetes often have issues with their bladders, such as not completely emptying it when urinating or not going frequently enough.¹² If urine stays in the bladder for too long, it can lead to infection.¹³
Less interest in sex
A decrease in libido due to diabetes can impact both men and women, but the cause is usually different. Studies have found that for men, it usually has to do with diabetes’ impact on testosterone levels.¹⁴ However, it’s a bit more complex for women and individuals assigned female at birth.
One of the primary issues is diabetes’ influence on one’s ability to enjoy sex. Vaginal dryness caused by nerve damage is twice as common in women with diabetes.¹⁵ Vaginal dryness may also be due to reduced blood flow, medications or hormonal changes.¹⁶ The resulting discomfort or pain can lead to a decreased interest in sex.
Other signs and symptoms of diabetes
Regardless of sex, other common signs of diabetes can include:
Needing to go to the bathroom more than usual is a common early sign of diabetes. When there's too much sugar in your blood, your kidneys work overtime to process it through urination.¹⁷
Unquenchable thirst is another sign of diabetes (and yes, it can lead to frequent urination.) If your kidneys are busy working to flush out blood sugar, they're also ridding the body of other fluids, resulting in greater than usual thirst.
If you practice good oral hygiene but notice a fruity odor on your breath, that could be a sign of ketoacidosis. Ketoacidosis is a potentially life-threatening complication of diabetes that happens when your insulin levels are too low to allow blood sugar into your cells.¹⁸
Blurred vision could be a sign your blood sugar levels are fluctuating dramatically, which can cause the lens of the eye to swell, leading to blurry eyesight. In most cases, treating diabetes to stabilize blood sugar will help vision improve near or return to your previous baseline.¹⁹
Unexplained weight loss
Another sign of diabetes is if you’re losing weight without dieting or exercising more than usual. When insulin isn’t working properly, your cells don’t get the glucose they need to operate, and your body is forced to rely on fat stores for energy instead, causing weight loss.²⁰
Frequent skin infections or suddenly itchy skin can also be a sign of diabetes. Those with high blood sugar or reduced blood flow to extremities, like the hands or feet, may experience more rashes and other skin problems.²¹
Low energy without clear cause can be a direct symptom of diabetes or it can be a complication of other diabetes symptoms, like waking up all night to use the bathroom. Research shows a sedentary lifestyle, which creates a higher risk of type 2 diabetes,²²²³ can also lead to fatigue.²⁴
Risks of diabetes in women by age group
While type 1 diabetes is more likely to develop in children or teenagers, type 2 typically is more common in people who are 45 and older.²⁵
Statistics show both men and women are more likely to develop type 2 diabetes in middle age. According to a national diabetes statistics report, in 2020, 26.8% of those 65 years and older had diabetes, while 17.5% of adults 45 to 64 and only 4.2% of adults 18 to 44 had it.²⁶
Do women of color need to worry about diabetes?
Diabetes is a leading cause of death for women; in 2017, it was responsible for nearly 3% of all female deaths in America.²⁷ When the stats from that year are adjusted for race, diabetes is deadlier for Black women (causing 4.5% of deaths in that group), American Indian or Alaska Native women (5.6%), Asian or Pacific Island women (4.1%) and Hispanic women (4.7%).²⁸
Diabetes is also much more likely to develop in all American women of color when compared with white American women.²⁹
Diabetes and reproductive health in women
Due to the relationship between blood sugar, insulin resistance and reproductive hormones (estrogen and progesterone), unusual menstruation may indicate uncontrolled diabetes.³⁰³¹ For example, one study found that women with type 1 diabetes had longer and heavier periods than those without diabetes.³²
Hormone levels change throughout the menstrual cycle and can impact blood sugar levels and insulin resistance.³³ A study of over 75,000 women even suggests that irregular and prolonged menstrual cycles were associated with a higher risk of eventually developing type 2 diabetes.³⁴
Regardless of sex, diabetes can create fertility issues.³⁵ Fertility problems in diabetic individuals who were assigned female at birth are usually linked conditions associated with diabetes, such as obesity³⁶ or polycystic ovarian syndrome (PCOS). PCOS affects as many as 5 million women in the US and is associated with insulin resistance and an increased likelihood of developing type 2 diabetes.³
Diabetes in pregnant women
Testing for and monitoring diabetes is important for all pregnant people, whether you have already been diagnosed as diabetic or not.
Type 1 or type 2 diabetes in pregnancy
In the case of diabetic individuals who become pregnant, uncontrolled diabetes can be dangerous for both the expecting parent and the baby. High blood sugar increases the risk of serious complications like preeclampsia (high blood pressure), miscarriage, birth defects, high birth weight or preterm birth.³⁸ Planning ahead of pregnancy, eating well, exercising, monitoring blood sugar levels — and most importantly, seeking guidance from your healthcare professional — are all ways you can help manage these health risks.³⁹
Gestational diabetes occurs when an individual develops diabetes while pregnant. This condition can occur in healthy people with no history of diabetes, and they often show no symptoms.⁴⁰ Due to this risk, doctors typically order a diabetes test between 24 and 28 weeks of pregnancy.⁴¹ A healthy diet and exercise can naturally help control gestational diabetes, but in some cases a doctor will prescribe insulin. Uncontrolled gestational diabetes can result in a baby being born with high blood sugar, birthing complications, high blood pressure, or low blood sugar.⁴²
When should you see your doctor?
If you are experiencing these symptoms of diabetes or have concerns, book an appointment with your doctor for further testing. You can also test your average blood sugar level with an at-home testing kit, but a chat with your healthcare professional is recommended, especially if you’re symptomatic.
Beyond the usual symptoms of diabetes (dehydration, fruity breath, energy loss, blurry vision, etc.), women with diabetes may experience frequent yeast infections, UTIs, low sex drive, unusual menstruation and fertility issues. Women and those assigned female at birth are more likely to experience health complications from diabetes, so if you have any concerns, be sure to talk to your healthcare provider.