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Review
. 2019 Oct;62(10):1761-1772.
doi: 10.1007/s00125-019-4939-5. Epub 2019 Aug 27.

Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course

Amy G Huebschmann  1   2 , Rachel R Huxley  3   4 , Wendy M Kohrt  1   5   6 , Philip Zeitler  7 , Judith G Regensteiner  1   2   8 , Jane E B Reusch  9   10   11
Affiliations
Review

Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course

Amy G Huebschmann et al. Diabetologia. 2019 Oct.

Abstract

By 2017 estimates, diabetes mellitus affects 425 million people globally; approximately 90-95% of these have type 2 diabetes. This narrative review highlights two domains of sex differences related to the burden of type 2 diabetes across the life span: sex differences in the prevalence and incidence of type 2 diabetes, and sex differences in the cardiovascular burden conferred by type 2 diabetes. In the presence of type 2 diabetes, the difference in the absolute rates of cardiovascular disease (CVD) between men and women lessens, albeit remaining higher in men. Large-scale observational studies suggest that type 2 diabetes confers 25-50% greater excess risk of incident CVD in women compared with men. Physiological and behavioural mechanisms that may underpin both the observed sex differences in the prevalence of type 2 diabetes and the associated cardiovascular burden are discussed in this review. Gender differences in social behavioural norms and disparities in provider-level treatment patterns are also highlighted, but not described in detail. We conclude by discussing research gaps in this area that are worthy of further investigation.

Keywords: Cardiovascular disease; Diabetes mellitus, type 2; Life course development; Lifestyle; Obesity; Review; Sex differences; Type 2 diabetes.

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Figures

Fig. 1
Fig. 1
Sex differences in insulin resistance across the life span. Adapted from [9] with permission from Elsevier. This figure is available as part of a downloadable slideset
Fig. 2
Fig. 2
Obesity levels are higher among women than men at the time of type 2 diabetes diagnosis. (a, b) Sex differences in the prevalence of diabetes/impaired glucose tolerance (IGT) (a) and being overweight (BMI ≥25) or obese (BMI ≥30) (b) by age (adapted from [22]). (c) BMI at diabetes diagnosis by age (adapted from [41] by permission from Springer Nature). This figure is available as part of a downloadable slideset
See this image and copyright information in PMC

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