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  • Print publication year: 2004
  • Online publication date: August 2009

15 - Diabetes in mid-life women

from Part III - Disease prevention


The incidence and prevalence of diabetes is increasing worldwide. This chapter examines the diagnosis, prevention, and management of diabetes in mid-life women. In mid life, type 2 diabetes is the most common type of diabetes. Diagnostic criteria and classification schemes for diabetes have been proposed and published by the American Diabetes Association (ADA) and World Health Organization (WHO). Risk factors for the development of type 2 diabetes include obesity, physical inactivity, age, and family history of type 2 diabetes. Good glycemic control, through education, self-blood glucose monitoring, diet, and exercise, as well as medications, is important to minimize the increased health risks associated with diabetes. Since the complications of diabetes, including heart attack, stroke, blindness, end-stage renal disease, and lower-extremity amputation, are more prevalent with advancing age and duration of diabetes, mid-life women with diabetes must advocate for their own healthcare management.
American Diabetes Association:
The Endocrine Society:
Information on diabetes and menopause:
King, H., Aubert, R. E. and Herman, W. H.Global burden of diabetes, 1995–2025. Diabet. Care 1998; 21:1414–31
Harris, M. I., Flegal, K. M., Cowie, C. C., et al.Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. Diabet. Care 1998; 21:518–24
Gu, K., Cowie, C. C. and Harris, M. I.Mortality in adults with and without diabetes in a national cohort of the U.S. population, 1971–1993. Diabet. Care 1998; 21:1138–45
American Diabetes Association. Screening for diabetes. Diabet. Care 2002; 25(supp 1):S21–4
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabet. Care 2002; 25(supp 1):S5–20
World Health Organization. Diabetes Mellitus: Report of a WHO Study Group. Geneva: World Health Organization; 1985
American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabet. Care 2002; 25(supp 1):S33–49
American Diabetes Association. Tests of glycemia in diabetes. Diabet. Care 2002; 25(supp 1):S97–9
American Diabetes Association and NIDDK. The prevention or delay of type 2 diabetes. Diabet. Care 2002; 25:742–9
Colditz, G. A., Willett, W. C., Rotnitzky, A. and Manson, J. E.Weight gain as a risk factor for clinical diabetes mellitus in women. Ann. Intern. Med. 1995; 122:481–6
Folsom, A. R., Kushi, L. H. and Hong, C. P.Physical activity and incident diabetes mellitus in postmenopausal women. Am. J. Publ. Health 2000; 90:134–8
Knowler, W. C., Barret-Connor, E., Fowler, S. E., et al.Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 2002; 346:393–403
Poirier, L. and Coburn, K. Women and Diabetes. Alexandria, VA: American Diabetes Association; 1997
Samaras, K., Hayward, C., Sullivan, D., Kelly, R. and Campbell, L.Effects of postmenopausal hormone replacement therapy on central abdominal fat, glycemic control, lipid metabolism, and vascular factors in type 2 diabetes. Diabet. Care. 1999; 22:1401–7
Matthews, K. A., Meilahn, E., Kuller, L. H., et al.Menopause and risk factors for coronary heart disease. N. Engl. J. Med. 1989; 321:641–6
The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Intervention (PEPI) trial. J. Am. Med. Assoc. 1995; 273:199–208
Andersson, B., Mattsson, L. A., Hahn, I., et al.Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with noninsulin-dependent diabetes. J. Clin. Endocrinol. Metab. 1997; 82:638–43
Stratton, I. M., Adler, A. I., Neil, H. A., et al.Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br. Med. J. 2000; 321:405–12
Ferrara, A., Karter, A., Ackerson, L., Liu, J. and Selby, J.Hormone replacement therapy is associated with better glycaemic control in women with type 2 diabetes. Diabet. Care 2001; 24:1144–50
Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. J. Am. Med. Assoc. 2002; 288:321–23
Grady, D. and the HERS research group. Cardiovascular disease outcomes during 6.8 years of hormone therapy. J. Am. Med. Assoc. 2002; 288:49–57
Osteoporosis prevention, diagnosis, and therapy. NIHConsens. Statement 2000; 17:1–36
Surwit, R., Tilburg, M., Zucker, N., et al.Stress management improves long-term glycemic control in type 2 diabetes. Diabet. Care 2002; 25:30–34
Dorman, J., Steenkiste, A., Foley, T., et al.Menopause in type 1 diabetic women: is it premature?Diabetes 2001; 50:1857–62
American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabet. Care 2002; 25(supp 1):S50–60
American Diabetes Association. Diabetes mellitus and exercise. Diabet. Care 2002; 25(supp 1):S64–8
Devlin, J. T. and Ruderman, N. The Health Professional's Guide to Diabetes and Exercise. Alexandria VA: American Diabetes Association; 1995
American Diabetes Association. Implications of the Diabetes Control and Complications Trial. Diabet. Care 2002; 25(supp 1):S25–7
Feinglos, M. N. and Bethel, M. A.Treatment of type 2 diabetes mellitus. Med. Clin. North Am. 1998; 82:757–90
Inzucchi, S. E.Oral antihyperglycemic therapy for type 2 diabetes. Scientific review. J. Am. Med. Assoc. 2002; 287:360–72
Diabetes Control and Complications Trial research group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N. Engl. J. Med. 1993; 329:977–86
UK Prospective Diabetes Study Group. Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352:837–53
Poirier, L. and Coburn, K. Women and Diabetes. Alexandria, VA: American Diabetes Association; 1997
Howard, B., Cowan, L., Go, O., et al.Adverse effects of diabetes on multiple cardiovascular disease risk factors in women. Diabet. Care 1998; 21:1258–65.