Fight gender-based neglect

Women and diabetes

Diabetes affects women more severely not because of medical reasons but because of their unique biological, cultural and socio-economic circumstances.

A recent study on youth with diabetes, undertaken by DAWN (Diabetes, Attitudes, Wishes and Needs) Youth, in collaboration with the International Diabetes Federation (IDF) and the International Society for Paediatric and Adolescent Diabetes (ISPAD), revealed that in India almost double the women with diabetes as compared to men felt that diabetes has been a cause of concern for them and their families, when thinking about marriage.

Girls more often develop a potentially fatal condition called diabetic ketoacidosis because their insulin dose is suddenly reduced or stopped by parents. As a diabetes educator with over nine years in counselling people with diabetes and their families, I have come across countless cases of gender-based neglect.

In one such instance, I met with two siblings with type 1 diabetes. The girl’s sugar was checked once in a week but the boy’s was checked twice a day. The girl later succumbed to complications due to lack of adequate treatment. Often, the effectiveness of insulin therapy is compromised by a lack of support from family members and the community. Many parents, even those belonging to educated and financially sound families, perceive a girl with diabetes as a burden who is difficult to marry off.

Even if the girl has well controlled diabetes it is difficult to find her a husband, they told the researchers, as society thinks that the girl may pass on diabetes to the child.
The fact is that the risk of having a child with type 1 diabetes is lower if it is the mother — rather than the father — who has diabetes. If the father has it, the risk is about 1 in 10 (10 per cent). If the mother has type 1 diabetes and is age 25 or younger when the child is born, the risk is reduced to 1 in 25 (4 per cent) and if the mother is over age 25, the risk drops to 1 in 100 — virtually the same as the average population.

Pregnancy and diabetes
Increasingly, pregnancies are associated with diabetes either through women previously known to have diabetes (both type 1 and type 2) becoming pregnant (pre-gestational diabetes) or through diabetes being first recognised during pregnancy (gestational diabetes). Unfortunately, many women try to avoid insulin because of social myths. Preconception counselling and optimal control of diabetes before, during, and after pregnancy minimise maternal and foetal risks, including congenital malformation.  In a majority of cases, women with well controlled diabetes often carry their baby to term without any problems. However between 30 and 70 per cent of women manifesting gestational diabetes will go on to develop type 2 diabetes over time.

In today’s world, a woman is more keen that her husband gets a health checkup and proper treatment but her own health check up is put off for a variety of reasons. It is important to realise that women are equally prone to develop diabetes as men. Women with diabetes in many countries face discrimination professionally, socially as well as at home. Oscar-winning actress Halle Berry and Nicole Johnson, Miss America 1999, are living examples of women successfully living with diabetes. If you are a woman with diabetes, remember that you can choose either to be controlled by diabetes or you can control diabetes. So, take control now.