I live with Type 2 diabetes. So do millions of women living in Canada. Diabetes is a chronic condition, and there are no vacations, no time off. It requires constant consideration and care. For women, it can be a weighty burden atop our overflowing to-do lists and burnt-out bandwidths. And on top of all that, until very recently most research into chronic health conditions has simply ignored sex and gender as factors worth considering or excluded women as research participants.
In fact, a recent Heart and Stroke Canada report highlighted several disparities women continue to experience in the prevention and treatment of heart attack and stroke. And we know that these health inequities are even more acute for women of colour.
Pregnant women are also routinely excluded from clinical research; a study revealed that out of 558 Phase 4 trials, only five (one per cent) were designed purposely for pregnant women. Menopause is another women’s health issue that the scientific community knows far too little about despite it impacting every woman on the planet that lives long enough to become menopausal.
Women deserve better, including more thoughtfully designed clinical and research studies, particularly when it comes to chronic conditions.
Thankfully, over the past decade we have seen pioneering researchers, often female-identifying, take up this mantle and explore these previously neglected topics.
Women deserve better, particularly when it comes to chronic conditions.
Researchers like Carol Huang, whose work aims to develop a better understanding of what causes gestational diabetes. This is critical work since gestational diabetes is one of the most common medical problems in pregnancy, affecting up to 20 per cent of pregnant women. What is particularly worrying is that 50 per cent of these women progress to Type 2 diabetes within 10 years of their gestational diabetes diagnosis. Huang’s research will help health-care professionals design strategies to delay and prevent this progression – a level of care and curiosity into a historically marginalized health issue that will significantly improve the health outcomes for millions.
Advancing our understanding of the difference between men’s and women’s cellular biology, Elizabeth Rideout is looking into why men’s beta cells respond differently than women’s beta cells. With more clues into how female beta cells respond to stress, scientists can develop better treatments to relieve beta cell stress, improve insulin production and better manage diabetes in both women and men.
Another scientist, Jane Yardley, is focusing on another woefully unexplored health challenge. Her work shines a light on women living with Type 1 diabetes who reach menopause, at which point the risk of heart disease increases swiftly. They also lose bone and muscle faster, making them more likely to become frail.
Exercise can prevent these problems, but in people with Type 1 diabetes, hitting the gym can also make their blood sugar levels unstable. Current advice for treatment, drug dosage, diet and exercise might not work well for older women with Type 1 diabetes as most treatment studies test younger people. Yardley is working to change this by investigating how different types of exercise affect blood sugar levels in menopausal women with Type 1 diabetes, research that could help unlock new treatment plans.
As a woman living with a chronic health condition, my hope is that this is just the beginning. As the world celebrates another International Women’s Day, I urge Canadians to reflect on what gender equality really means. We view health care as a fundamental human right that should be accessible and equitable for all. So too should be the science and studies that are foundational to our health-care systems.