With cases of obesity and type 2 diabetes at record numbers in the United States, new research reveals that women with “pre-diabetes” may experience blood vessel dysfunction, clot formation and high blood pressure more often than men, possibly making them more vulnerable to heart disease in the future.“Pre-diabetes is a condition, not a disease, when fasting blood sugar is 100-125 mg/dl,” explains Richard P. Donahue, Ph.D., M.P.H., professor at the School of Public Health and Health Professions at the State University of New York at Buffalo and lead author of the study. In other words, in pre-diabetes, blood glucose levels are higher than normal, but not high enough to reach the diagnostic criteria for diabetes. Studies show that a considerable number of people with pre-diabetes develop type 2 diabetes later in life.
It has long been established that differences between women and men exist when it comes to diabetes and heart disease risk. Some studies have shown that diabetic women have a greater risk of coronary heart disease than diabetic men. Other studies have shown that the risk of a heart attack is higher in female diabetics than in male diabetics. This new study suggests that even before diabetes is diagnosed, there may be significant differences that contribute to the risk of heart disease.
“The reasons why women with type 2 diabetes are at higher risk (for heart disease) than male diabetics are not well known,” Donahue said. “Some studies suggest that women may have more coronary microvascular disease, as opposed to disease in the larger coronary arteries, but this is only a hypothesis.”
From this study, it is feasible to speculate that pre-diabetic women may be more prone to blood vessel dysfunction and clotting problems than pre-diabetic men, but more studies are needed to further examine the role sex—the biological status of being a woman or a man—plays in pre-diabetes and the risk of heart disease.
What is known for certain is that lifestyle changes in pre-diabetics, regardless of sex, can delay or prevent the onset of type 2 diabetes. Researchers have proven that healthy dietary choices and moderate physical activity can ward off the development of type 2 diabetes and further lower the risk of heart disease and stroke.
Diagnosing pre-diabetes in patients is very important because treating it may not only prevent the development of diabetes, it can also prevent the many, unwanted complications.
“Women should know their glucose value and have it measure annually from age 45 onwards,” Donahue said. “If it continues on an upward trend, the primary care docs may consider more intensive therapy for risk factors for heart disease including, hypertension and LDL cholesterol.”
Currently, the American Diabetes Association recommends that all adults aged 45 years and older be considered for diabetes screening by their health care provider every three years. However, the following people are at higher risk and should also consider pre-diabetes screening:
People with a family history of type 2 diabetes
Overweight or obese people (Body Mass Index greater than 25)
Women with a history of gestational diabetes
Women with polycystic ovary syndrome;
People with a sedentary lifestyle
High risk minority groups including: African Americans, Native Americans and LatinosPre-diabetes can develop at any age and many American children and adolescents now have the condition. You also do not have to be significantly overweight to develop it, so individuals who do not eat a healthy diet or do not exercise regularly should be aware of the condition and talk to their health care providers.
Jennifer Wider, M.D.
Society for Women’s Health Research
March 8, 2007
