The vulnerability of women to diabetes

Afflicting an estimated one-fifth of Barbados’ adult population, Type 2 diabetes is a national concern.  But what is not so publicly known is that the disease is killing women earlier and restricting them more physically, even in sex.

Some aspects of the subdued suffering of women hit by this silent but debilitating non-communicable disease were revealed as Barbados joined the world this week in observing World Diabetes Day and some persons got together at the Lloyd Erskine Sandiford Centre to talk about Women in Diabetes.

The presentations of a panel comprising former International Diabetes Federation (IDF) president, Maria Alva; Chair-elect of the North American and Caribbean Region of the IDF, Glynis Beaton; and former National Organization of Women president, Nalita Gajadhar brought into the limelight the largely unrecognized facts. Namely, that as a lifestyle disease, Type 2 diabetes takes a heavier toll on women because of their Caribbean traditional roles, and this gender agonizes over women-specific related illnesses that society does not want to hear about.

Beaton, a diabetic, said that despite men and women coming down with Type 2 diabetes, “vaginal itching is not a part of a man’s living with Diabetes, pain is not a part for men; yeast infection; intercourse with pain; thrush; vaginal dryness”.

Relating her encounters as an activist, Gajadhar, who also has diabetes, said, “most of the time” what she finds offensive is that women leave the doctor’s office “feeling very low, depressed because they’ve been told how bad they are.”

“I’ve also had to talk to women who’ve been told how promiscuous they are because they go to the doctor with the itching of the vagina, and that odour . . . as if we can’t associate diabetes, and should not associate diabetes with the yeast infection, and we know that to be so.”

Beaton also spoke of other unseen areas of suffering for females with diabetes. “Us women suffer more than men with depression. Women with diabetes are more prone to poor blood sugar control, and that leads to hyper-glycemia or hypo-glycemia,” she said.

“We suffer with high cholesterol more than men. Our good cholesterol goes down faster than men,” she said of the estimated 200 million women worldwide with diabetes.

Beaton also spoke of how women ‘dread’ obesity. Pointing to her tummy, she said, “we would like to have her flat so that we can really dress but diabetes would not permit us”.

“Women are usually longer livers,” she noted. “That’s not the case if you have diabetes.”

Beaton said there is a 1971 to 2000 study that showed the death rate for diabetes affected men went down while that of women went up.

Dr Heather Armstrong, health officer in the Ministry of Health, spoke of factors, or social determinants, combined with the maternal lifestyle of Caribbean women as causes for females in the region falling victim to diabetes.

She said this is brought on by “the conditions in your environment which have an effect on your health, your ability to function; the quality of life outcomes that appear in your life. It could be where you live, what type of occupation you have, the level of education”.

“Being a female in itself is a social determinant for Type 2 diabetes in the Caribbean,” she said, pointing to research done by Dr Natasha Sobers-Grannum “where she did a systematic review of all the studies that were done in the Caribbean which showed that if you are female, it is more likely that you would have a diagnosis of Type 2 diabetes later on in life”.

Type 2 diabetes is described as a lifestyle disease because contracting this illness has largely to do with poor eating habits and a lack of physical activity.

“Women tend to participate in physical activities less than men,” Dr Armstrong pointed out.  “You find the men outside doing more strenuous work, and us as females sometimes because of our jobs or we have to take care of children, we’re not as active as the men.”

She spoke of “the process of balancing multiple competing demands by women in families where chronic illness existed”. “Imagine when you’re taking care of a husband, you’re taking care of your child who has a chronic illness, but you yourself you have a chronic illness but you are the nurturer, you are the caregiver, so other persons come first and you put yourself last”.

Dr Armstrong delved into this island’s past circumstances, some of which still exist today for many women. “Women, especially in Barbados when we look through our history, you would have a woman who is the sole breadwinner for the family. She would have eight or nine children.,” Dr Armstrong said.

She added: “And she was the one who made sure that those children went to school and had what they needed. But she also had to deal with whatever issues she had for herself. And we find with women that as caregivers, we tend to take care of everybody else, make sure that everybody else was good and leave herself for last . . . . That plays a part in terms of our ability to manage our chronic illnesses.”

Dr Armstrong said that the unrecognized sacrifices of women lead to the stigma and social finger pointing with suggestions such as, “if you would control your eating, you wouldn’t have this condition. How irresponsible that for a woman your age you’ve let yourself go to the point that you’ve developed diabetes”.

But Alva, who was diagnosed with Type One diabetes at age six, countered with a motivational talk insisting that women with diabetes must not sit back and take their circumstances as their only fate.

“The perspective that you have about yourself and your lifestyle is what makes the difference. If you feel that you are left behind, you will be left behind. If you try to strive on, you will strive on.

“You have a disorder, diabetes, but many other people have other disorders that are much worse.”

“Stop using your diabetes as an excuse. It is not an excuse to miss school. It is not an excuse to miss work. It is not an excuse for anything,” Alva said in a motivational presentation talking mainly about her experiences before the panel discussion.

Source: by George Alleyne

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