Scientists have studied gender differences in men and women with diabetes
After the diagnosis of type 2 diabetes mellitus, women and men may develop different health trajectories. This conclusion was reached by British scientists who tracked the condition of almost 29 thousand people over several years. Women were more likely to experience psychiatric disorders, while men had earlier experienced cardiovascular and renal complications. About why the risks for women and men may differ after the same diagnosis and which complications are more common, see the Izvestia article.
Diabetes is not just about sugar levels
The study is published in the journal PLOS Medicine. Scientists from Queen Mary University of London analyzed the anonymized medical data of 28,720 people who were first diagnosed with type 2 diabetes between 2010 and 2020. The participants were followed for an average of 6.8 years and tracked which conditions developed after diagnosis and in what order.
Type 2 diabetes is a chronic metabolic disorder in which the body stops using insulin effectively enough or does not produce it in the required amount. As a result, the blood glucose level remains elevated. Over time, the disease can affect different body systems and increase the risk of cardiovascular diseases, kidney damage, and other complications.
In the study, men made up 62% of the entire group. The average age at the time of diagnosis was about 54 years, while women on average became ill a little later — at about 56 years old. During the follow-up period, 39% of all participants had at least one significant condition after the onset of diabetes. The researchers assessed hypertension, cardiovascular diseases, end-stage chronic kidney disease, anxiety and depressive disorders, somatoform disorders, and death.
At the same time, scientists looked not only at which complication appeared, but also at the sequence of events. To do this, they used a multi-stage statistical model that allows them to trace a person's transition from one state to another. This approach made it possible to compare not individual complications, but entire disease trajectories in women and men.
Women were more likely to have anxiety and depression.
One of the most notable differences the researchers found was in relation to mental health. After the diagnosis of type 2 diabetes, 8.1% of women were diagnosed with mental disorders compared to 5.3% of men. These included anxiety, depressive, and somatoform disorders in the study.
However, the differences are especially noticeable in younger participants. The authors note that young women with diabetes had psychiatric complications earlier and more often than they expected. Therefore, the researchers believe that psychological screening may become an important part of the standard follow-up for women with type 2 diabetes.
At the same time, it cannot be argued that diabetes itself directly causes mental disorder in women. The work was observational, so it shows patterns and a sequence of states, but does not establish a cause-and-effect relationship. In addition, scientists admit that part of the difference may be explained by the peculiarities of seeking medical help: women in the study, on average, visited doctors more often and received more long-term appointments than men.
The authors also found that the combination of type 2 diabetes and psychiatric disorder was associated with earlier mortality in both sexes. The difference in one of the trajectories was particularly noticeable: among people who were diagnosed with a mental disorder after diabetes and then died, men died on average about nine years earlier than women — at 70 and 61, respectively.
At the same time, women were generally more likely to use medical services. During the follow-up period, they had more requests for primary medical care and a higher volume of long-term appointments. The researchers believe that this should also be taken into account when interpreting the differences between men and women: the results may reflect not only the features of the course of diseases, but also the difference in how actively people seek medical help.
Men used to have heart and kidney problems.
A different pattern was observed in men after the diagnosis of type 2 diabetes. They were more likely to develop trajectories related to cardiovascular diseases and end-stage kidney disease: 8.4% versus 5.3% in women.
Another difference concerned the timing of complications. The researchers note that as men aged, the likelihood of cardiovascular and renal complications increased. Men over the age of 60 were more likely to develop such conditions after diabetes than women in the same age group. For women, on the contrary, mental disorders remained a more characteristic trajectory after diagnosis in all age groups.
At the same time, hypertension was the most frequent event for both sides, regardless of age — 21.1% for men and 20.2% for women. It could become the next stage after the diagnosis of diabetes, and then be combined with other complications. This, according to the authors, shows that patient monitoring should take into account not only gender, but also age and existing diseases.
Scientists believe that the results may help make diabetes treatment more personalized. For women, especially younger ones, the authors suggest paying more attention to early detection of anxiety and depression. For men, earlier control of cardiovascular and renal risks and measures that help them stay in the medical monitoring system may be important areas. The authors also emphasize that the results require further study, including in order to understand how the differences identified are due to biology, behavioral characteristics and seeking medical help.
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