Men are from Mars and Women are from Venus. They have diverse roles to perform. Man the “protector” and woman the “child bearer”. Since their biology is another, they fare differently in disorder states particularly chronic illnesses like diabetes, hypercholesterolemia, and heart disease.
In childhood, girls normally have type1 DM while type2 DM is generally present in adults. PCOS – Polycystic Ovarian Syndrome, an insulin-resistant state can adversely influence body image and menstrual cycles during adolescence. Young girls become overweight, sad, and have altered metabolic profiles. This can affect their fertility and married life.
Marriage itself is taboo, particularly in India. Brides with diabetes are seen upon as liable partners in marriage. The overall feeling is that all the next generation will have diabetes. This is not true. Further, mood swings through hyper and hypoglycemia can give an increase to stress in married life. This needs a lot of understanding to stay together.
Infertility is on the increase, essentially because of insulin resistance. Women in childbearing age require to take proper care both in reducing body weight and maintaining sugars.
Gestational diabetes ie women who become diabetic for the earliest time during pregnancy and those already having diabetes, who become pregnant require frequent monitoring to keep optimum sugar control. Maternal difficulties like pre-eclampsia, hypertension, stillbirth, miscarriages, and preterm delivery are normal. Difficulties in newborns like large-to-weight children and natural abnormalities are to be avoided. Then again the women are put on Insulin treatment, with the withdrawal of tablets, which can give rise to marked fluctuations of blood glucose.
Cardiovascular disease & atherosclerosis is on the increase in diabetes women, while there is a decline in the same in diabetic men. Women tend to have lipid abnormalities that are more atherogenic. They have a larger number of small dense low-density lipoproteins, which pass through the arteries easily increasing the burden of occlusive artery disease and then increasing the rate of heart attack and cardiac failure which is more popular in women than men more so after menopause.
Menopause itself is an extremely insulin resistant and atherogenic state. The female hormones like estrogen and progesterone which have a protective action on blood vessels and metabolism are suddenly decreased. This enhances the already existing abnormalities and makes them susceptible to cardiovascular and metabolic complications.
Women biologically live large than men raising the burden of the single elderly.
HOW WOMEN ARE DIFFERENT?
Each cell in the body is either male or female (XX or XY). The defects in genes in XX is shown in women but is protected by the Y genes in men. Hereditary defective genes causing disease therefore will manifest in women simply. When compounded with a sedentary lifestyle and caloric rich foods causing obesity, lifestyle disorders like diabetes, hypertension, heart disease are more aggressive. Metabolic changes are secondary to the above produce inequality of thyroid, adrenal, pituitary, and sex hormonal requirements.
WHAT IS TO BE DONE?
- Diabetes prevention procedures must focus on maternal health and nutrition and health behaviors prioritising specific needs of women.
- Promote opportunities for physical exercise in adolescent girls to adopt a healthy lifestyle.
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