Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course
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...
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| Veröffentlicht in: | Diabetologia Jg. 62; H. 10; S. 1761 - 1772 |
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| Hauptverfasser: | , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.10.2019
Springer Nature B.V |
| Schlagworte: | |
| ISSN: | 0012-186X, 1432-0428, 1432-0428 |
| Online-Zugang: | Volltext |
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| 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. |
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| AbstractList | 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.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. 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. |
| Author | Huxley, Rachel R. Zeitler, Philip Huebschmann, Amy G. Regensteiner, Judith G. Kohrt, Wendy M. Reusch, Jane E. B. |
| AuthorAffiliation | 1 Center for Women’s Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO 80045, USA 6 Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA 5 Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA 2 Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA 3 College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia 8 Division of Cardiology, University of Colorado School of Medicine (CU-SOM), Aurora, CO, USA 7 Division of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA 4 The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia 9 Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA |
| AuthorAffiliation_xml | – name: 9 Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA – name: 2 Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA – name: 7 Division of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA – name: 4 The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia – name: 5 Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA – name: 8 Division of Cardiology, University of Colorado School of Medicine (CU-SOM), Aurora, CO, USA – name: 1 Center for Women’s Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO 80045, USA – name: 3 College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia – name: 6 Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA |
| Author_xml | – sequence: 1 givenname: Amy G. surname: Huebschmann fullname: Huebschmann, Amy G. organization: Center for Women’s Health Research, University of Colorado School of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine – sequence: 2 givenname: Rachel R. surname: Huxley fullname: Huxley, Rachel R. organization: College of Science, Health and Engineering, La Trobe University, The George Institute for Global Health, University of New South Wales – sequence: 3 givenname: Wendy M. surname: Kohrt fullname: Kohrt, Wendy M. organization: Center for Women’s Health Research, University of Colorado School of Medicine, Division of Geriatric Medicine, University of Colorado School of Medicine, Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center – sequence: 4 givenname: Philip surname: Zeitler fullname: Zeitler, Philip organization: Division of Pediatric Endocrinology, University of Colorado School of Medicine – sequence: 5 givenname: Judith G. surname: Regensteiner fullname: Regensteiner, Judith G. organization: Center for Women’s Health Research, University of Colorado School of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Division of Cardiology, University of Colorado School of Medicine (CU-SOM) – sequence: 6 givenname: Jane E. B. surname: Reusch fullname: Reusch, Jane E. B. email: jane.reusch@ucdenver.edu organization: Center for Women’s Health Research, University of Colorado School of Medicine, Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31451872$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Springer-Verlag GmbH Germany, part of Springer Nature 2019 Diabetologia is a copyright of Springer, (2019). All Rights Reserved. |
| Copyright_xml | – notice: Springer-Verlag GmbH Germany, part of Springer Nature 2019 – notice: Diabetologia is a copyright of Springer, (2019). All Rights Reserved. |
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| DOI | 10.1007/s00125-019-4939-5 |
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| ISSN | 0012-186X 1432-0428 |
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| Issue | 10 |
| Keywords | Type 2 diabetes Obesity Diabetes mellitus, type 2 Life course development Cardiovascular disease Lifestyle Sex differences Review |
| Language | English |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Literature Review-3 ObjectType-Review-3 content type line 23 Contribution statement The authors accept full responsibility for the content of this paper. All authors contributed to developing the scope and design of this narrative review article. With medical informatics consultation, AGH and JEBR conducted the primary literature review and identified the appropriate articles for inclusion. AGH, JGR and JEBR are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data presented. AGH and JEBR wrote the initial draft of the paper, RRH and JGR drafted additional tables and sub-sections of the revised paper in response to reviewer feedback, RRH, WMK, JGR and PZ each critically reviewed and edited the manuscript. All authors had an opportunity to contribute to the conclusions of the review and approved the version to be published. |
| OpenAccessLink | http://dx.doi.org/10.1007/s00125-019-4939-5 |
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| PublicationDate | 2019-10-01 |
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| PublicationPlace | Berlin/Heidelberg |
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| PublicationSubtitle | Clinical, Translational and Experimental Diabetes and Metabolism |
| PublicationTitle | Diabetologia |
| PublicationTitleAbbrev | Diabetologia |
| PublicationTitleAlternate | Diabetologia |
| PublicationYear | 2019 |
| Publisher | Springer Berlin Heidelberg Springer Nature B.V |
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| SubjectTerms | Cardiovascular diseases Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Gender differences Health risk assessment Human Physiology Internal Medicine Life span Medicine Medicine & Public Health Metabolic Diseases Obesity Review Sex differences |
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| Title | Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course |
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