(Vienna, 19-04-2023) A MedUni Vienna overview study reveals gender-specific differences in the diagnosis and pathogenesis of type 2 diabetes in women and men. Type 2 diabetes is diagnosed later in women than men; women also have more risk factors for the disease. This has a negative impact on the course of the disease in women, particularly with respect to heart attacks and strokes. This study was published in the renowned journal "Diabetologia".
The study by Alexandra Kautzky-Willer, Michael Leutner and Jürgen Harreiter from MedUni Vienna's Department of Medicine III shows that diabetes mellitus affects more men than women worldwide; however, type 2 diabetes is often diagnosed earlier in men than in women. Men are generally less overweight at the time of diagnosis and have a higher insulin resistance and more abdominal fat due to their genetic predisposition and hormonal situation. In women, conversely, the diagnosis of type 2 diabetes is often only made over the course of examinations during pregnancy. Gestational diabetes is also considered to be a strong risk factor for later-occurring type 2 diabetes in.
"Hormonal irregularities in women, such as menstrual irregularities or polycystic ovary syndrome, should be given more attention, as they can influence the risk of type 2 diabetes," explains metabolism expert Alexandra Kautzky-Willer, "chronic stress and obesity are also risk factors in women." The experts recommend ruling out prediabetes, the preliminary stage of diabetes, before having children. It is also pointed out that the risk profile of women changes after menopause due to the drop in oestrogen as a hormonal protective factor and their risk of type 2 diabetes and cardiovascular disease increases sharply. Hormone replacement therapy can significantly reduce the risk of diabetes in menopausal women.
Early diagnose and therapy significant
The study also highlights that the current thresholds to diagnose a type 2 diabetes in women may be challenging, as fasting blood glucose levels and HbA1c (long-term glucose) levels are often still within the normal range during the early stages. "It is necessary for gender differences in the diagnosis and course of type 2 diabetes to be taken into account to better protect women's health," Kautzky-Willer adds.
The authors emphasise the significance of early diagnosis and consistent drug therapy in women with type 2 diabetes to improve the pathogenesis and reduce the risk of heart attack and stroke.
Including psychosocial factors in women
Psychosocial factors, such as a lower level of education, trauma, emotional stress to depression and poor socioeconomic status, also play a major role in Type -2 diabetes in women,. In addition, in the case of pre-existing diabetes, there is the specific diabetes distress that occurs with worries, fears and stress related to the demanding disease. Kautzky-Willer: "This is a greater issue in women, not least because of a different planning of pregnancy at childbearing age".
Publication: Diabetologia
Sex differences in Type 2 diabetes
Alexandra Kautzky-Willer, Michael Leutner, Jürgen Harreiter
doi: 10.1007/s00125-023-05891-x
https://link.springer.com/article/10.1007/s00125-023-05891-x