Diabetes and Women

Rhoda couldn’t contain her joy when the test result came in positive. Her excitement wasn’t only due to the fact that it was her first; but also because she and Dayo had been kicking it for the past 12 years without success. She wasn’t even aware of it until she was about four weeks gone. It was now eight weeks and Rhoda got scheduled for her first antenatal appointment. At the hospital, she complained to the doctor of her increased thirst that was quite unusual. She also mentioned that she urinated more frequently, was always hungry and sometimes experienced fuzziness in her vision. The doctor observed her and noted that she was also overweight. Although the symptoms Rhoda described were all common occurrences in pregnancy, the doctor suspected they may be indicative of gestational diabetes. If she had gestational diabetes, she might develop complications which could affect her and the baby. The doctor therefore recommended an OGTT (Oral Glucose Tolerance Test) so it could be ascertained whether Rhoda had gestational diabetes or might be at risk of other health problems. Rhoda in this story is a fictional character but diabetes and its impact on women worldwide isn’t.
According to data released by the World Health Organization, WHO in 2016, diabetes is the 9th leading cause of death in women globally; causing 2.1 million deaths each year. The International Diabetes Federation has also noted that over 199 million women are living with diabetes and this number is projected to reach 313 million by 2040. This escalating threat posed by diabetes made the International Diabetes Federation and WHO to adopt the theme: Women and Diabetes – our right to a healthy future, for the 2017 World Diabetes Day. The reason for choosing this theme came off the fact that women, owing to socioeconomic conditions especially in developing economies were experiencing barriers in accessing cost-effective means to prevention of the disease. It was also observed that because of male dominance and ‘gender politics’ in these developing countries, women who had diabetes faced severe stigmatization and discrimination. This in turn limited their chances of getting diagnosed early as well as receiving affordable treatment and care. Since 1991 when the International Diabetes Federation picked November 14 as World Diabetes Day to commemorate the birth day of the discoverer of insulin (the major hormone involved in regulating blood glucose levels) and the United Nations passed a resolution in December 2006 to affirm it, November 14 every year has become a day to raise awareness on diabetes, its complications and prevention as well as how to provide care to people living with the condition. While a lot of information about diabetes is already out there and it will be no use wasting ample space and time going over what is common knowledge; it might help to refresh our minds as well as educate a few who perhaps have no knowledge about diabetes or even clarify misconceptions.
Diabetes is a complex, chronic and metabolic disease caused by high levels of blood sugar (glucose) in the body. This occurs when the body doesn’t produce or use insulin appropriately. Insulin is a hormone made in the pancreas, an organ close to the stomach. Insulin helps the glucose from the food we eat get into body's cells for energy. If our bodies do not make enough insulin or uses it incorrectly, the glucose stays and builds up in the
blood. Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts us at risk of other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney failure. There are three types of diabetes:
Type 1 diabetes. Type 1 diabetes is an autoimmune disease; which means that the body's immune (protection) system attacks and destroys the cells in the pancreas that make insulin. In essence, if someone has type 1 diabetes, the body does not produce insulin and therefore insulin must be taken every day. Type 1 diabetes usually develops in childhood, but it can occur at any age. It is mostly inherited from parental genes. There is a higher risk of someone developing Type 1 diabetes if they live in colder climates, have a family history of diabetes or have suffered from certain viral diseases.                                                                      

   Type 2 diabetes. This is the most common type of diabetes. One can get type 2 diabetes at any age, even during childhood. In type 2 diabetes, the body does not make sufficient insulin or is not capable of using its own insulin properly. When this occurs, blood glucose levels rise. Type 2 diabetes can arise if someone is overweight, has a family history of the disease, suffer from stroke or some form of heart disease. People who do not have a good exercise regimen are also at risk of type 2 diabetes.

§  Gestational diabetes. Gestational diabetes is a type of diabetes that happens only during pregnancy. Gestational diabetes can cause health problems for the baby and the mother if not attended to. Although gestational diabetes stops immediately after childbirth, having diabetes during pregnancy raises the risk for type 2 diabetes later on.
It is important to note here that although diabetes affects as much men and women alike, there is a higher risk of developing other health problems in women than in men. The most common complication of diabetes for women may include but not limited to lower rate of survival in case of a heart attack, they also stand a greater risk of going blind or twice as likely to suffer from depression which increases the risk for diabetes. In other cases, women with diabetes also find it very difficult to get pregnant; if they eventually get pregnant, a lot of problems may arise during pregnancy. Women with diabetes are also at risk of developing recurring urinary and vaginal infections.  Aside these, they have a predisposition to heart disease, stroke, renal failure, leg amputation and hearing loss.
This is why there is need to promote the importance of equitable and affordable access for all women with diabetes or at risk of the disease. For instance, an adequate and affordable health insurance coverage will go a long way in helping women with diabetes access the supplies, medications, education and health care they need to manage their diabetes and prevent, or treat, complications. Another important thing to do is that diabetes educators can encourage women who suffer from diabetes or at risk to form small groups where resources and education about diabetes can be shared. This will enable them manage the disease and its related outcomes. Discrimination and stigmatization also increase the burden of diabetes on women. This is why in advanced democracies, there are laws in place to give these set of women protection as well as offer them legal assistance. Advocacy groups especially in developing nations, apart from educating people on ending discrimination or stigmatization towards women living with diabetes can go further to provide legal assistance and protection for women. A greater goal would be to push for legislation that protects people, especially women against any form of discrimination due to their health status.
 Furthermore, a critical element in managing diabetes involves the role of primary care physicians. A 2012 research by Brigham and Women’s Hospital, USA showed ample evidence that people who had consistent primary care from physicians had better health outcomes. These insights can be leveraged upon by national governments to frame health policies and interventions that will increase women’s access to primary care. There is a lot more that can be done to ensure women’s right to a healthy future. This article has only highlighted a few in relation to diabetes. In concluding, one cannot erase the fact that diseases are better combated or managed through sustained collaborations and partnerships. The United Nations has already created that platform and framework for nations to synergise through the Sustainable Development Goals (SDGs). One of such goals, specifically goal number three aims to address healthy life outcomes and wellbeing for people of all ages. This subset contains women who are so vital and critical to nation building and socioeconomic transformation. I will recommend therefore that beyond the rhetoric and publicity that the SDGs have received, workable action plans should be implemented in order to actualize this goal. Like in other areas, the focus should be narrowed to women. When we enable women who live with diabetes have access and right to a healthy future, we have by default secured the future.    

Ikiba Onuoya Joel is an educator, creative writer and founder of Collaborative and Creative Innovations Centre (COCRIC), a social enterprise enabling labour market inclusion for skills-challenged working-age youths in Nigeria. Joel has been educated on Human-centred Design by the John Sloan Dickey Centre for International Understanding, Dartmouth College USA. He also holds a Bachelor’s Degree in Microbiology, University of Nigeria, Nsukka; a certification in Quality Management as well as competencies in Project and Business Management. His work experience of nearly a decade spans education, industrial engineering and the energy sector. Joel volunteers for causes in education, children and social services. He also convenes the ‘Teachers Think and Collaborate’ forum for educators. He is author of Shadows in the Greying Sun; a prose fiction on Huntington disease. He resides in Yenagoa with his wife Kate and can be reached by e-mail at franklyjoel@yahoo.co.uk.


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