Cancer often has no specific symptoms, so it is important that you limit your risk factors and undergo appropriate cancer screening.
Nevertheless, you need to know which symptoms might point to cancer. You do not want to ignore a warning that might lead to early diagnosis and possibly to a cure.
Diabetes means that your blood sugar is too high. Your blood always has some sugar in it because the body uses sugar for energy; it's the fuel that keeps you going. But too much sugar in the blood is not good for your health.
Your body changes most of the food you eat into sugar. Your blood takes the sugar to the cells throughout your body. The sugar needs insulin to get into the body's cells. Insulin is a hormone made in the pancreas, an organ near the stomach. The pancreas releases insulin into the blood. Insulin helps the sugar from food get into body cells. If your body does not make enough insulin or the insulin does not work right, the sugar can't get into the cells, so it stays in the blood. This makes your blood sugar level high, causing you to have diabetes.
If not controlled, diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations (having a toe or foot removed, for example), and nerve damage. In women, diabetes can cause problems during pregnancy and make it more likely that your baby will be born with birth defects.
Pre-diabetes means your blood sugar is higher than normal but lower than the diabetes range. It also means you are at risk of getting type 2 diabetes and heart disease. The good news is: You can reduce the risk of getting diabetes and even return to normal blood sugar levels with modest weight loss and moderate physical activity. If you are told you have pre-diabetes, have your blood glucose (sugar) checked again in 1 to 2 years.
The three main types of diabetes are:
About 20 million Americans have diabetes, about half of whom are women. As many as one third do not know they have diabetes.
Type 1 diabetes occurs at about the same rate in men and women, but it is more common in Whites than in minorities.
Type 2 diabetes is more common in older people, mainly in people who are overweight. It is more common in African Americans, Hispanic Americans/Latinos, and American Indians.
Type 1 and type 2 diabetes — The exact causes of both types of diabetes are still not known. Type 1 diabetes tends to show up after a person is exposed to a trigger, such as a virus, which can start an attack on the cells in the pancreas that make insulin. There is no one cause for type 2 diabetes, but it seems to run in families, and most people who get type 2 diabetes are overweight.
Gestational diabetes — Changing hormones and weight gain are part of a healthy pregnancy, but these changes make it hard for your body to keep up with its need for insulin. When that happens, your body doesn't get the energy it needs from the foods you eat.
Things that can put you at risk for diabetes include:
If you're at least 45-years-old, you should get tested for diabetes, and then you should be tested again every 3 years. If you're 45 or older and overweight (Calculate your Body Mass Index (BMI) you may want to get tested more often. If you're younger than 45, overweight, and have one or more of the risk factors listed in "Am I at Risk for Diabetes?" you should get tested now. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose (blood sugar), pre-diabetes, or diabetes.
If you have one or more of these signs, see your doctor.
Many people with diabetes live healthy and full lives. By following your doctor's instructions and eating right, you can too. Here are the things you'll need to do to keep your diabetes in check:
Talk to your doctor about other things you can do to take good care of yourself. Taking care of your diabetes can help prevent serious problems in your eyes, kidneys, nerves, gums and teeth, and blood vessels.
Taking care of yourself when you have gestational diabetes is very much like taking care of yourself when you have other types of diabetes. But it can be a little scary when you're pregnant and you also have a new condition to take care of. Don't worry. Many women who've had gestational diabetes have gone on to have healthy babies. Here are the things you'll need to do:
| Blood glucose targets for most women with gestational diabetes | |
| On awakening | not above 95 mg/dL |
| 1 hour after a meal | not above 140 mg/dL |
| 2 hours after a meal | not above 120 mg/dL |
Each time you check your blood sugar, write down the results in a record book. Take the book with you when you visit your health care team. If your results are often out of range, your health care team will suggest ways you can reach your targets.
There is no cure for diabetes at this time. The National Institutes of Health (NIH) is doing research in hopes of finding cures for both type 1 and type 2 diabetes. Many different approaches to curing diabetes are being studied, and researchers are making progress.
Yes. The best way to prevent diabetes is to make some lifestyle changes:
By Dr. Ranjeet S. Baral
Cardiovascular death rate in developed nations is decreasing due to advanced treatment technology. However, the same cannot be said for women. Due to an aging population, the death rate is in fact increasing in them. Coronary heart disease and stroke are the two most common causes of death in women in most developed countries. Cardiovascular death claims almost 55% of all death in women which is more than all forms of cancer deaths combined or simply one in two women would die of heart disease compared to one in twenty five who would die of breast cancer. The media often erroneously reports breast cancer as being the leading cause of death in women. This misconception has to be addressed as breast cancer claims only one tenth of lives compared to heart disease in women.
It’s of paramount importance to bring increased awareness of heart disease in women because almost 65% of deaths occur in those with no previous symptoms. Women during fertile age have a lower risk of cardiac events but this protection fades away after menopause. The response to therapy may also differ in women because of endogenous hormone levels, lower body weight and higher fat proportions. There have been reports where aspirin tends to have protective effects for stroke in women but not for heart attacks.
The major risk factors for coronary heart disease in women are smoking, hypertension, diabetes, obesity, sedentary lifestyle, poor nutrition and dyslipidemia. Among these risk factors, gender differences have been noted in diabetes and dyslipidemia. Age is an important risk factor for both men and women but women are on average ten years older when they develop coronary heart disease. Smoking is the leading risk factor with more than 50% of heart attacks being attributed to tobacco. We have to realize that cessation of smoking brings risk of heart disease to the non-smokers level within 3-5 years. It’s distressing to know that the demographic pattern shows increase in younger women smoking worldwide when the male counterparts show a decline. Moreover, the use of oral contraceptives in young women who smoke, further increases the risk.
More women than men develop hypertension as they get older and we know that control of hypertension reduces the risk of both stroke and heart disease. Data reveals that more than 50% of women after the age of 55 have high cholesterol levels and that there are significant treatment benefits for post-menopausal women with dyslipidemia.
Risk of coronary heart disease mortality associated with diabetes is again higher in women than men. This gender based difference may be due to a particular deleterious effect of diabetes on lipids and blood pressure. Obesity and sedentary lifestyle are parallel risk factors for both men and women.
Oral contraceptives raise blood pressure and pose additional risk in women who smoke. They do not increase the risk of heart attack on women who do not have other risk factors associated with heart disease. There is a threefold increase in stroke for those taking pills, which increases to tenfold for smokers. It has been found that low dose pills containing less than 50ug estrogens are safe except in smokers. Also, lifetime costs are significantly higher for women than for men of the same age group (over 65) when the majority of strokes occur. Women also have greater tendency to suffer from atypical chest pain or to complain of abdominal pain, nausea, fatigue and shortness of breath. As women tend to have heart attacks later in life than men, they often have other diseases that mask cardiac symptoms. Coronary heart disease is more often of the silent type in women. Also, some of the diagnostic tests used to diagnose heart diseases like the TMT (treadmill test) are less accurate in women. Moreover, HRT (hormone replacement therapy) may induce false positive results. There is also an increased chance of SVD (single vessel disease) being missed out in women. Similarly, breast tissue may result in false positive results with even recent diagnostic investigations like myocardial perfusion thallium test. However, SPECT (computed CT), calcium scoring and exercise ECHO are valuable diagnostic tools in women. Thus, women with heart disease tend to be both under investigated and under treated when actually the female gender is strongly associated with increased risk for heart disease. The one-year post heart attack mortality risk is 41% in women compared to 27% for men. Similarly, in hospitals, mortality rate is 13% for women compared to 7% for men. By and large, women have smaller coronary blood vessels and intervention procedures like angioplasty and by-pass surgery show higher adverse effects like local bleeding and vessel dissection during and immediate post procedures in women. Thus, women with coronary heart disease have most to gain from using risk reduction strategies. HRT (hormone replacement therapy) is controversial to say the least. Uniil recently, affluent women used to be prescribed hormones routinely at menopause for symptom relief, osteoporosis and cardiac protection. However, the latest research data has not shown any remarkable benefit for the heart. Thus, HRT is not solely prescribed for cardiac protection. Women who elected to take hormones were educated and thus had favorable levels of blood pressure, cholesterol, insulin, body weight, alcohol intake and physical activity. Thus, the amount of estrogen protection could be exaggerated. It has also been shown that most risk factors associated with HRT increases with therapy duration. Some are of the view that short term relief of menopausal symptoms with HRT will be worth the small absolute increase in risk for breast cancer, emboli and heart disease for many women provided the therapy is used for the shortest period of time necessary to successfully treat menopausal symptoms. However, until more definitive data is available, HRT should be based on a woman’s baseline risk for heart disease, weighing the potential net benefit on overall health.
In conclusion, all female groups should acknowledge the gender difference in heart disease. Medication has a role in primary prevention in selected groups. However, major emphasis should be placed on lifestyle modifications, smoking, diabetes, obesity, diet and physical activity. Also, awareness of heart disease in women including the delayed onset on them needs to be emphasized at different forum levels of education/seminar programs. As I write this article, international trials such as WTH (women take heart) & WISE (women with ischaemia syndrome evaluation) have just been released in March where they have emphatically concluded that women must aggressively manage their risk factors if they are to live a longer, healthier life.
Dr. Baral is the consultant cardiologist at Ganga Lal Heart Institute & NORVIC Hospital. Ph: 4436612/4437610, Mobile: 98510-53577
