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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Bibliographic Details
Published in:Diabetologia Vol. 62; no. 10; pp. 1761 - 1772
Main Authors: Huebschmann, Amy G., Huxley, Rachel R., Kohrt, Wendy M., Zeitler, Philip, Regensteiner, Judith G., Reusch, Jane E. B.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019
Springer Nature B.V
Subjects:
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
Type 2 diabetes
Obesity
Diabetes mellitus, type 2
Life course development
Cardiovascular disease
Lifestyle
Sex differences
Review
ISSN:0012-186X, 1432-0428, 1432-0428
Online Access:Get full text
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Summary: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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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.
ISSN:0012-186X
1432-0428
1432-0428
DOI:10.1007/s00125-019-4939-5