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15 - Diabetes in mid-life women

from Part III - Disease prevention

Published online by Cambridge University Press:  21 August 2009

By
Phillippa Miranda  and
Diana McNeill
Edited by
Jo Ann Rosenfeld
Phillippa Miranda
Affiliation:
Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
Diana McNeill
Affiliation:
Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
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Summary

Case: a 51-year-old woman who has had type 2 diabetes for five years is managed with metformin, diet, and exercise. She notes worsening hyperglycemia, but attention to diet and exercise does not seem to improve glycemic control as it has in the past. She mentions to her physician that she has missed her last two menstrual periods and that she seems to be a “bit more edgy.” She wonders whether there is a correlation between her worsening diabetes control and her menstrual changes.

Definitions

Diabetes mellitus refers to a group of common metabolic disorders characterized by hyperglycemia. Diabetes may be type 1 (juvenile-onset or insulin-dependent diabetes mellitus – IDDM), type 2 (adult-onset or non-insulin-dependent diabetes mellitus – NIDDM), or gestational (during pregnancy). In type 1 diabetes, hyperglycemia is caused by an absolute deficiency of insulin secretion. In type 2 diabetes, hyperglycemia is caused by a combination of insulin resistance and inadequate compensatory insulin secretory response, with a relative, not absolute, insulin deficiency.

The most common type of diabetes in mid life is type 2 diabetes, often caused by a combination of inherited and environmental factors and lifestyle choices. Type 2 diabetes is associated with numerous metabolic abnormalities, including reduced insulin secretion, increased hepatic glucose production, decreased glucose uptake by muscle and adipose tissue, and dyslipidemia. These metabolic abnormalities underlie the complications of diabetes, including heart attack, stroke, blindness, end-stage renal disease, and lower-extremity amputation.

Keywords

blood glucosedietexerciseglycemic controlobesitymid-life womenphysical inactivityheart attackstroketype 2 diabetes
Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
 , pp. 253 - 272
Publisher: Cambridge University Press
Print publication year: 2004

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References

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  • Diabetes in mid-life women
    • By Phillippa Miranda, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA, Diana McNeill, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.015
Available formats
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  • Diabetes in mid-life women
    • By Phillippa Miranda, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA, Diana McNeill, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diabetes in mid-life women
    • By Phillippa Miranda, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA, Diana McNeill, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book: Women's Health in Mid-Life
  • Online publication: 21 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545672.015
Available formats
×