India has the unenviable distinction of being a global diabetes hotspot. More than 100 million people, including more than 50 million women, live with diabetes in our country.
While the prevalence of diabetes, its complications and risk factors are largely similar across genders, women with diabetes face unique challenges in managing their health.
We have shown that obesity, a major risk factor for type 2 diabetes (the most common form of diabetes) is more prevalent among women. Also, women face a higher risk of developing metabolic ill-health during important life-course events such as pregnancy and menopause, leading to an increased risk of diabetes as well as difficulties in controlling sugar levels among those who already have diabetes.
Gestational diabetes mellitus is a unique form of diabetes detected during pregnancy. This condition can cause serious ill-effects for the mother and baby if not detected and treated on time. Even though the condition usually resolves after delivery, the women remain at high risk of developing diabetes for the rest of their life.
Menopause brings hormonal changes that impact insulin sensitivity. Weight gain and mood swings further challenge diabetes control. Identifying challenges and tailoring appropriate management strategies are key to maintaining health.
Dietary challenges
Preventing weight gain and promoting weight loss by means of diet and physical activity are key to preventing and treating type 2 diabetes. Unfortunately, women face several challenges in adhering to a healthy lifestyle. Higher financial dependency, poorer accessibility to healthcare facilities, lower literacy and fewer avenues for psychological support (due to stigma associated with seeking help for mental health) contribute to poor diabetes control among women. Poor diet and high stress levels related to juggling multiple roles makes it difficult for them to focus on their own health.
Societal norms limit access to exercise, further complicating diabetes management. We have shown in the national ICMR-INDIAB study of more than 1.2 lakh individuals across India that more than 60 per cent of women are physically inactive, and nearly 90 per cent have no leisure-time physical activity at all. Preventing and managing diabetes in women requires gender-specific strategies and intervention. Identification of the unique challenges faced by women in managing chronic diseases like diabetes would be the first step. Providing support to women and girls at all phases of life — puberty, pregnancy, lactation and menopause — will help minimise the fluctuations in metabolic control that occur at these stages.
Creating awareness among women on healthy diets has benefits that go beyond the individual — as women are often the primary decision-makers for the family’s diet.
Fitness first
Women in India face barriers to fitness — cultural restrictions on outdoor activities, limited access to health clubs, and even clothing constraints. To address these barriers, we created ‘Thandav’ — an exercise combining high-intensity interval training and dance. It requires no special equipment, can be done at home, and appeals to young people.
Women with diabetes face unique health challenges, requiring awareness and action. Cultural barriers, hormonal changes, and limited access to fitness make diabetes management difficult. However, innovative solutions and proactive health initiatives offer hope.
By embracing lifestyle changes and community support, women can take control of their wellness and lead healthier lives.
(The writer is Managing Director and Consultant, Dr Mohan’s Diabetes Specialities Centre. Views are personal)
