Women, diabetes and heart disease: Dawn's story

Most women lead hectic lives. They have places to go, projects to do, people to care for.

Women with diabetes have even more to manage. For instance, they must control their glucose levels to help prevent kidney, nerve and eye damage. And diabetes can take a major toll on the heart.

Dawn McCarter, RN, knows the risks better than most. Diagnosed with type 1 diabetes at the age of 15, she's now a diabetes nurse clinician at Abbott Northwestern Hospital's Diabetes Center.

A healthy pregnancy

Diabetes meant additional risks when McCarter became pregnant with her daughter Olivia. But intensive monitoring and blood sugar control ensured that both she and Olivia remained healthy throughout the pregnancy.

Long-range complications

Although her diabetes is under control, McCarter says she worries about the complications of her disease. "My concern is down the road, like maybe 10 years from now. The longer you have diabetes, the greater the chance of having complications."

With diabetes, high blood sugar levels can damage blood vessels and increase the risk of atherosclerosis, a clogging of the arteries that leads to heart disease. Conditions that often accompany diabetes -- such as high blood pressure, high cholesterol and obesity -- can add to the danger.

"Clinical evidence suggests that diabetes is a particularly important risk factor (for heart disease) in women," says leading women's health and diabetes researcher Elizabeth Barrett-Connor, MD.

Compared to people without diabetes, women with the disease tend to have lower levels of HDL ("good") cholesterol and higher levels of fats in their blood. That combination can result in a type of LDL ("bad") cholesterol that easily packs into artery-clogging plaque. All told, diabetes increases a woman’s risk of heart disease by three to seven times.

In addition to glucose control, the American Diabetes Association recommends these heart disease prevention steps:

• blood pressure control: The suggested target is below 130/80 millimeters of mercury (mm Hg). Blood pressure should be checked at every doctor's visit.
• cholesterol control: The suggested target for LDL is below 100 milligrams per deciliter (mg/dl) of blood. Cholesterol should be checked at least once yearly.

Exercising daily, eating a healthy diet, taking medicines as prescribed, and not smoking, also help lower the risk for heart disease.

Following her own advice

McCarter follows the advice she gives to her patients. "I watch my intake of carbohydrates, and I have regular medical follow-up. Keeping your average blood sugar levels below a certain point reduces your risk of complications by 50 percent."

McCarter says she believes many of her patients find it helpful to have a nurse with diabetes. "I think I'm able to help them be realistic. No one is perfect in managing their diabetes. The important thing is to keep trying your best to keep it under control."

Related Links

Diabetes Condition Center

Diabetes in pregnancy

Heart Health Condition Center

First published: 09/16/2002
Last updated: 11/14/2003

Reviewed by: Paul Kleeberg, MD, medical director, Internet/Intranet Services, Allina Hospitals & Clinics