Men are more likely to suffer serious consequences from diabetes than women

Men are at greater risk of serious consequences from diabetes (types 1 and 2) than women, suggests a long-term study published online in the Journal of Epidemiology & Community Health.

Rates of cardiovascular disease, leg, foot and kidney complications, and sight-threatening eye diseases such as diabetic retinopathy are higher in men, regardless of age how long they have had diabetes - less or more than 10 years, study results show.

The global prevalence of diabetes is roughly equal among men and women and is expected to reach 783 million by 2045, according to researchers.

Although cardiovascular disease is more common in men overall, it is unclear whether this gender difference translates into diabetes-related complications, the researchers note. It is also unclear whether life expectancy with diabetes influences these differences, they add.

To further explore this question, the researchers used survey data from the 45 and Up Study, Australia, a large prospective study of 267,357 people over 45 years of age living in New South Wales (NSW).

These data were linked to the medical records of 25,713 people, all of whom had either type 1 or type 2 diabetes, to track the development of underlying health problems associated with diabetes.

These problems include cardiovascular disease (coronary heart disease, mini-stroke, or transient ischemic attack, stroke, heart failure, diabetic cardiomyopathy); eye problems (cataracts, diabetic retinopathy); leg and foot problems (peripheral neuropathy (nerve damage), ulcers, cellulite, osteomyelitis (bone inflammation), peripheral vascular disease (poor circulation), as well as minor and major amputations); and kidney problems (acute kidney failure, chronic kidney disease, chronic kidney failure, dialysisand kidney transplantation).

Nearly half the group was aged 60 to 74, and more than half (57%; 14,697) were men, most of whom were overweight (39% vs. 29% for women) and had a history of heart disease. p>

Although approximately the same proportion of men and women were current smokers, more men were former smokers: 51% versus 29% for women.

Of the 19,277 (75%) people with diabetes whose age was recorded at diagnosis, 58% had lived with the disease for less than ten years and 42% for 10 years or more.

Men had higher rates and were at greater risk of diabetes-related complications.

Over a mean follow-up of 10 years and after controlling for age, 44% of men experienced a CVD complication and 57% experienced an eye complication. Also, 25% of men had leg/foot complications, and 35% had kidney complications. The corresponding figures for women were 31%, 61%, 18% and 25%.

Overall, men were 51% more likely to develop cardiovascular disease, 47% more likely to have leg and foot complications, and 55% more likely to have kidney complications compared to women.

Although there was little difference in the overall risk of eye complications between genders, men were at slightly higher risk (14%) of diabetic retinopathy.

Although the incidence of complications increased with the duration of life with diabetes in both men and women, differences between the sexes in the incidence of complications persisted.

The researchers noted that men in the study were more likely to have known risk factors. They may also be less likely to make lifestyle changes, take preventative medications or get medical checkups to reduce risks, they suggest.

This is an observational study, and as such no definitive conclusions can be drawn about causative factors, and people with a history of complications were excluded from the study. Information was also not available on potentially influencing factors such as diabetes medications, glucose control, blood fat control, and blood pressure control.

But based on their findings, the researchers suggest: “For every 1,000 people with diabetes, our data suggest that on average 37, 52, 21, and 32 people will develop cardiovascular, eye, lower extremity, and kidney complications each year, respectively.”

While the risks of complications are lower in women with diabetes, they are still high, the researchers emphasize.

And they conclude: “Although men with diabetes are at higher risk of developing complications, particularly cardiovascular, kidney, and lower extremity complications, the incidence of complications is high in both sexes.

“The similar difference between the sexes for people with shorter and longer diabetes durations highlights the need for targeted screening and complication prevention strategies from the time of diabetes diagnosis.

“Further research into the mechanisms underlying the observed sex differences in diabetes complications is needed to inform targeted interventions».