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These studies suggest that women with diabetes may experience menstrual abnormalities, depressive symptoms, urinary tract issues, atypical coronary symptoms, and sexual dysfunction.
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Women with Type 1 Diabetes (DM1) often experience hyperandrogenism and PCOS due to the high doses of exogenous insulin used for strict metabolic control. Studies show that the prevalence of PCOS in adult women with DM1 ranges from 12% to 40%, depending on the diagnostic criteria used. Common symptoms include mild hirsutism (30%) and biochemical hyperandrogenism (20%). Additionally, menstrual abnormalities are observed in 20% of these women, with 50% showing polycystic ovarian morphology.
Young women with insulin-dependent diabetes have a higher prevalence of eating disorders, such as anorexia nervosa and bulimia, compared to non-diabetic women. These eating disorders are associated with a high incidence of diabetic complications, including retinopathy, nephropathy, and neuropathy. Notably, acute painful polyneuropathy often coincides with the peak of weight reduction in anorexia nervosa, with pain remission occurring as weight is regained.
Aging and obesity significantly worsen LUTS in diabetic women. Glucosuria is variably associated with urodynamic parameters but is significantly linked to urinary tract infections (UTIs) and incontinence. Severe nocturia in diabetic patients is a marker for cardiovascular risks and increased mortality. Diabetic women are also at higher risk for UTIs caused by virulent, extended-spectrum β-lactamase-producing bacteria.
Women with a history of gestational diabetes (GDM) are at high risk for developing Type 2 Diabetes (T2D). Mild to moderate depressive symptoms in these women are associated with pathological glucose metabolism, higher body mass index (BMI), increased systolic blood pressure, and higher abdominal visceral fat volume. These depressive symptoms can help identify women at risk for unfavorable metabolic profiles.
In postmenopausal women with diabetes, glucose control influences the severity of menopausal symptoms. Women with poor glucose control (HbA1c > 7%) report higher severity of menopausal symptoms, including muscle aches and joint pain, compared to those with better glucose control (HbA1c ≤ 7%) and non-diabetic women.
A significant proportion of insulin-dependent diabetic women experience changes in blood glucose levels or glycosuria during the premenstrual and menstrual phases. These changes are more common in women who suffer from premenstrual syndrome (PMS). Diabetic women also tend to have later menarche and more irregular menstrual cycles compared to non-diabetic women.
Women with diabetes may present with atypical symptoms of acute coronary syndrome (ACS), such as shortness of breath, rather than the classic chest pain. This atypical presentation can complicate the timely diagnosis and treatment of ACS in diabetic women.
Depressive symptoms are associated with an increased risk of developing Type 2 Diabetes in women. Studies indicate that women with depressive symptoms have a higher relative risk of developing T2D, even after adjusting for BMI and other factors.
Female sexual dysfunction (FSD) is more prevalent in women with Type 1 Diabetes (T1D) and is often associated with urinary incontinence (UI) and lower urinary tract symptoms (LUTS). Depression significantly mediates the relationship between LUTS/UI and FSD, highlighting the need for comprehensive mental health assessments in these patients.
Women with diabetes experience a range of symptoms that can significantly impact their quality of life. These include hyperandrogenism, eating disorders, LUTS, depressive symptoms, and complications related to glucose control. Understanding these symptoms and their interconnections is crucial for providing effective care and improving outcomes for diabetic women.
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