Type 2 Diabetes Can Take a Different Toll on Women vs. Men

After receiving a diagnosis of type 2 diabetes, your risk of experiencing additional health conditions in the years that follow may depend on whether you’re male or female.

“Our research revealed not just which complications show up, but how this wasn’t the same story for men and women,” says lead author Fabiola Eto, PhD, post doctoral research associate with the Wolfson Institute of Population Health at Queen Mary University of London. “Knowing roughly when a complication is likely to happen — and for whom — could provide insights into preventing it.”

Study Revealed Differences and Some Similarities Between Men and Women

In the analysis, published in the journal PLoS Medicine, Dr. Eto and her team used medical records to follow nearly 29,000 adults with type 2 diabetes for up to 10 years. Subjects averaged in age from 54 to 56 at diabetes onset.

The investigators discovered that about 2 out of 5 individuals diagnosed between 2010 and 2020 had at least one significant new health complication within about seven years.

The research discovered that, for both men and women, hypertension (high blood pressure) was the most frequent condition to be diagnosed following type 2 diabetes onset.

But the findings also highlighted a few differences between men and women’s trajectories after a type 2 diabetes diagnosis:

• Men were more likely than women to be diagnosed with high blood pressure (21.1 percent versus 20.2 percent)
• Men were more likely than women to be diagnosed with cardiovascular disease and end-stage renal disease (8.4 percent versus 5.3 percent).
• Women were more likely than men to be diagnosed with mental health conditions (8.1 percent versus 5.3 percent).

Ajay Rao, MD, chief of endocrinology, diabetes, and metabolism at Temple Health in Philadelphia, who was not involved in the research, calls these differences “clinically meaningful.”

Mental Health Issues After a Diabetes Diagnosis Pose a Special Risk

The researchers were surprised to note one similarity between women and men in the study: “Those who developed a mental health condition after their diabetes diagnosis died earlier than people on any other path we tracked, earlier even than those who developed heart or kidney disease,” Eto says.

The men died about nine years earlier than the women, the study found. In general men tend to seek out healthcare less often than women do, Dr. Rao notes, which might help explain these early deaths.

“There’s more healthcare utilization and engagement among women compared with men, so women are potentially getting assessed more for mental health disorders and other issues,” he says.

Eto speculates that depression and anxiety can make it harder to maintain self-care — sticking with medications, monitoring blood sugar, and attending health appointments.

Study Reveals a Need for Tailored Interventions

Rao praised the investigation for its rigorous analysis of a large database and its goal of highlighting how sex differences may influence diabetes care.

But he notes that the study findings can only show a link between sex differences and type 2 diabetes outcomes, not a cause-and-effect connection. “Further studies need to be done to clarify these associations,” he says.

Still, the research highlights the need for healthcare strategies that address both physical and mental health diagnoses for people with type diabetes.

Based on the results, Eto suggests that:

• Doctors may want to proactively offer mental health screening as part of ongoing diabetes care, since that’s where the earliest and clearest sex difference showed up.
• Women especially might want to keep an eye on their mental health in the years after a diabetes diagnosis.
• For men, more frequent contact with medical providers might offer important opportunities for better cardiovascular and renal health outcomes.
• Both men and women need to be aware that high blood pressure was the single most common complication to develop in the years after a diabetes diagnosis, regardless of sex or age, so that’s worth watching closely.