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Gender And Diabetes

Sex And Gender Differences In Risk, Pathophysiology And Complications Of Type 2 Diabetes Mellitus

Sex And Gender Differences In Risk, Pathophysiology And Complications Of Type 2 Diabetes Mellitus

Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus Gender Medicine Unit (A.K.-W., J.H.), Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria; and Metabolic Unit (G.P.), Institute of Neuroscience, National Research Council, 35127 Padua, Italy Address requests for reprints to: Professor Alexandra Kautzky-Willer, MD, Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University Vienna, Whringer Grtel 1820, 1090 Vienna, Austria., E-mail: [email protected] . This article is published under the terms of the Creative Commons Attribution-Non Commercial License (CC-BY-NC; ). This article has been cited by other articles in PMC. The steep rise of type 2 diabetes mellitus (T2DM) and associated complications go along with mounting evidence of clinically important sex and gender differences. T2DM is more frequently diagnosed at lower age and body mass index in men; however, the most prominent risk factor, which is obesity, is more common in women. Generally, large sex-ratio differences across countries are observed. Diversities in biology, culture, lifestyle, environment, and socioeconomic status impact differences between males and females in predisposition, development, and clinical presentation. Genetic effects and epigenetic mechanisms, nutritional factors and sedentary lifestyle affect risk and complications differently in both sexes. Furthermore, sex hormones have a great impact on energy metabolism, body composition, vascular function, and inflammatory responses. Thus, endocrine imbalances relate to unfavorable cardiometabolic traits, observable in women with androgen exc Continue reading >>

Gender Differences In The Pathophysiology Of Diabetes: What Do We Know?

Gender Differences In The Pathophysiology Of Diabetes: What Do We Know?

This feature requires the newest version of Flash. You can download it here . Hi. I am Franck Mauvais-Jarvis, professor of medicine at Tulane University Health Sciences Center in New Orleans, Louisiana. This year at the American Diabetes Association 75th Scientific Sessions, I gave a talk[ 1 ] about the role of gender and sex hormones in diabetes. This is a very important topic because men and women have evolved different ways to store and use glucose; therefore, many aspects of the regulation of glucose homeostasis are different in men vs women. These differences have implications for the development of diabetes. For example, type 1 diabetes has a known gender dimorphism. More boys than girls develop type 1 diabetes, suggesting that the female hormones protect against type 1 diabetes. Type 2 diabetes also has a sex dimorphism in the human population, and after menopause and the loss of estrogen production, more women than men have diabetes. Even the prediabetes syndromes differ by sex. For example, impaired fasting glucose is mostly observed in men, whereas impaired glucose tolerance is observed more in women. Thus, most of these differences are believed to be the consequence of the effect of male and female hormones after puberty. As mentioned, estrogen protects and maintains insulin sensitivity and insulin secretion, and helps the insulin-producing beta cell of the pancreas adapt to metabolic stresses. These effects are mediated via estrogen receptors. When women stop producing estrogen at menopause, they become predisposed to type 2 diabetes. In men, testosterone is converted into estrogen, which has an antidiabetic action on the estrogen receptors in men. Most effects of androgen in men result from the effect of testosterone on the androgen receptor, which enhance Continue reading >>

Gender Differences In Diabetes Progression

Gender Differences In Diabetes Progression

Home / Conditions / Prediabetes / Gender Differences In Diabetes Progression Gender Differences In Diabetes Progression According to a BMJ study, men with prediabetes who increased their physical activity levels and women with prediabetes who reduced their waist circumference had lower risks of progressing to diabetes. Researchers found that older age and higher two-hour glucose and triglyceride levels increased the risk for progression to diabetes among men, while a family history of diabetes, hypertension at baseline and higher baseline waist circumference increased the risk for women. So men who increase their physical activity and women who lower their waist circumference may reduce some of their risk for progression from prediabetes to diabetes. The researchers evaluated data from 334 adults (mean age, 57.2 years; 209 women) with prediabetes between November 2002 and October 2014 to identify sex-related factors affecting 10-year prediabetes outcome. The objective was to investigate the gender-related affecting factors of prediabetes on its 10-year outcome, in a longitudinal study. Prediabetes, which presents before diabetes, has been increasing globally, and the number of people with prediabetes worldwide is estimated to reach 472 million by the year 2025. In 2010, the prevalence of prediabetes was estimated to reach 36.2% in the USA and 50.1% in China. Participants completed a questionnaire of demographic characteristics, personal and family medical history and lifestyle habits; researchers divided participants according to physical activity level with the lowest tertile designated inactive and the highest two tertiles as active. HbA1c, triglyceride and cholesterol levels were assessed at baseline and 10-year follow-up visits (mean follow-up, 10.8 years). There w Continue reading >>

Gender Disparities In Mortality In Patients With Type 1 Diabetes

Gender Disparities In Mortality In Patients With Type 1 Diabetes

Editor's Note: Commentary based on Huxley RR, Peters SAE, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015;3:198-206. Background It is known that type 1 diabetes leads to premature death. Type 1 diabetes, unlike other autoimmune diseases, affects both males and females equally. Although women generally have lower mortality than men, Huxley et al. examined mortality rates for those with type 1 diabetes to see if this gender protection extends to mortality in those with type 1 diabetes. Prior studies have shown that women often have inadequate control of diabetes compared to men. Although some small studies have shown that women with type 1 diabetes have higher mortality, this paper was the first meta-analysis to quantify sex differences in all-cause as well as cause-specific events and mortality in those with type 1 diabetes. Methods A meta-analysis of studies was performed that reported sex-specific standardized mortality ratio (SMR) or hazard ratios associated with type 1 diabetes for either all-cause mortality or various other outcomes. This analysis examined within-sex excess mortality due to type 1 diabetes. A random effects meta-analysis with inverse variance weighting was performed to obtain sex-specific pooled SMRs for all-cause mortality, or mortality from cardiovascular (CVD) disease, renal disease, cancer, accident or suicide, as well incident coronary heart disease (CHD) and stroke. Subgroup analyses were done by baseline year of data collection, by region, by duration of study follow-up, by age of study participants, type of study design, and by quality of study. Results Data from 214,114 individuals with type 1 diabetes from Continue reading >>

Men 'develop Diabetes More Easily'

Men 'develop Diabetes More Easily'

Researchers may have discovered why men may be more likely to develop type 2 diabetes than women, BBC News has reported. The broadcaster said that a new study has found men are biologically more susceptible and need to gain far less weight than women to develop the condition. In the study, Scottish researchers examined the records of 95,057 men and women with type 2 diabetes (a condition caused by too much glucose, a type of sugar, in the blood), lookingat their ages and body mass index (BMI) scores at the time of diagnosis.A clear trend was foundin their results, with men developing type 2 diabetes at a lower BMI than women of a similarage. The researchers have speculated on why this may be the case, and have offered theories that men may be less sensitive to insulin than women or that males tend to store fat around their organs rather than under the skin as women do. However, the proposed reasons are only theories and cannot be confirmed by this study, which examined a limited range of factors at a single point in time. Overall, the observation that men seem to develop type 2 diabetes at a lower BMI than women of the same age is worthy of further exploration. As Dr Victoria King, Head of Research at Diabetes UK, told the BBC: "It is worrying that men develop type 2 diabetes at a higher rate than their female counterparts. Research like this will help us understand reasons why and provide greater insight into what we can do to improve prevention of type 2 diabetes." The study was carried out by researchers from several Scottish research institutes, including the Scottish Diabetes Research Network Epidemiology Group at the University of Glasgow. The research received funding from the Wellcome Trust. The study was published in the peer-reviewed medical journal Diabetolo Continue reading >>

Sex And Gender In Diabetes

Sex And Gender In Diabetes

Diabetes is a complex metabolic disease characterised by elevated blood glucose (sugar) levels. The increased glucose levels cause serious damage, especially to the eye, kidney, nerves, heart and blood vessels. Insulin is a hormone produced by the pancreas that regulates blood glucose. Type 1 diabetes occurs when the pancreas produces no insulin based on impaired autoimmunity; its cause and preventative measures are largely unknown. Type 2 diabetes, which is the most common form, occurs when the body does not produce enough insulin and the insulin that is produced does not work properly. It often results from excessive body weight and lack of exercise, but genetic and environmental factors also play a role. Gestational Diabetes Mellitus (GDM) occurs in women during pregnancy.3 Oral glucose tolerance tests are useful tools for the detection of early forms of diabetes. Diabetes is the fourth most common cause of death in the European Union, accounting for over 9% of total health budget spending in the region. In 2013, diabetes affected an estimated 32 million people, over 8% of the population, in the EU. Every two minutes, someone in the EU dies from complications from a disease related to diabetes.16,17 Diabetes accounts for 11% deaths in Europe among those ages 20 to 79. More men die of diabetes than women under the age of 70, but women have a higher rate of death from diabetes than men after the age of 40. For women, diabetes is the 9th leading cause of death in highincome countries and is becoming one of the most common non-communicable diseases globally.4 Prevalence of diabetes is increasing in every country across Europe each year. Both men and women of different ethnic groups appear to have an increased risk of diabetes. For both men and women, the rate of diabete Continue reading >>

Differences By Sex In The Prevalence Of Diabetes Mellitus, Impaired Fasting Glycaemia And Impaired Glucose Tolerance In Sub-saharan Africa: A Systematic Review And Meta-analysis

Differences By Sex In The Prevalence Of Diabetes Mellitus, Impaired Fasting Glycaemia And Impaired Glucose Tolerance In Sub-saharan Africa: A Systematic Review And Meta-analysis

Esayas Haregot Hilawe a, Hiroshi Yatsuya b, Leo Kawaguchi a & Atsuko Aoyama a a. Department of Public Health and Health Systems, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. b. Fujita Health University School of Medicine, Toyoake, Japan. Correspondence to Esayas Haregot Hilawe (e-mail: [email protected]). Bulletin of the World Health Organization 2013;91:671-682D. doi: Introduction Increasing urbanization and the accompanying changes in lifestyle are leading to a burgeoning epidemic of chronic noncommunicable diseases in sub-Saharan Africa.1,2 At the same time, the prevalence of many acute communicable diseases is decreasing.1,2 In consequence, the inhabitants of sub-Saharan Africa are generally living longer and this increasing longevity will result in a rise in the future incidence of noncommunicable diseases in the region.1–3 Diabetes mellitus is one of the most prominent noncommunicable diseases that are undermining the health of the people in sub-Saharan Africa and placing additional burdens on health systems that are often already strained.4,5 In 2011, 14.7 million adults in the African Region of the World Health Organization (WHO) were estimated to be living with diabetes mellitus.6 Of all of WHO’s regions, the African Region is expected to have the largest proportional increase (90.5%) in the number of adult diabetics by 2030.6 Sex-related differences in lifestyle may lead to differences in the risk of developing diabetes mellitus and, in consequence, to differences in the prevalence of this condition in women and men.3 However, the relationship between a known risk factor for diabetes mellitus – such as obesity – and the development of symptomatic diabetes mellitus may not be simple. For example, in m Continue reading >>

How Diabetes Differs For Men And Women

How Diabetes Differs For Men And Women

Although anyone can develop type 2 diabetes, your lifestyle, age and family history can put you at a higher risk. Common signs of diabetes include weight loss or gain, increased thirst, frequent urination or urinary tract infections, tingling or numb extremities, and feeling lethargic all the time. Symptoms can develop gradually and can be somewhat difficult to notice; most people find out they are diabetic when they’re visiting the doctor for a different reason altogether. The Facts about Diabetes and Gender Recently, studies have revealed some differences in the impact of diabetes on women versus men. Statistics show that 11 percent of women in the United States age 20 and older have diabetes, a number just slightly less than men. One of the major differences is how the disease is diagnosed. The signs of diabetes in men tend to be more recognizable, making it easier for men to get diagnosed earlier. Men tend to develop type 2 diabetes at a younger age and at a lower weight, which means they receive more aggressive treatment sooner for both diabetes and the potential heart health risks it can bring. Women tend to be further along in the disease when they are diagnosed, making them far more susceptible to complications. Some of the ways diabetes symptoms in women have a greater impact on overall health include: Heart disease. Heart disease is the leading cause of death among women with diabetes. When a woman is diabetic, the risk for heart disease is six times higher than for women who do not have diabetes. Studies show that the risk of heart disease to women with diabetes is 50 percent higher than for men with diabetes. Hormonal problems. Women’s hormones can also affect the way they manage their diabetes; menopause can cause changes in blood sugar levels, and some Continue reading >>

Effect Of Age, Gender, And Diabetes On Excess Death In End-stage Renal Failure

Effect Of Age, Gender, And Diabetes On Excess Death In End-stage Renal Failure

Effect of Age, Gender, and Diabetes on Excess Death in End-Stage Renal Failure on behalf of the Association Rgionale des Nphrologues de RhneAlpes and the French Renal Epidemiology and Information Network (REIN) Registry *Department of Nephrology, Dialysis and Transplantation, Lyon Sud Hospital, Pierre-Bnite, and Service of Biostatistics, Hospices Civils de Lyon, UMR CNRS 5558, and Claude Bernard University, Lyon, France Dr. Emmanuel Villar, Service de Nphrologie, Dialyse et Transplantation, Centre Hospitalier Lyon Sud, 165, chemin du Grand Revoyet, 69495 Pierre Bnite Cedex, France. Phone: +33-4-72-67-87-14; Fax: +33-4-72-67-87-10; E-mail: emmanuel.villar{at}chu-lyon.fr Received for publication September 25, 2006. Life expectancy is short in elderly individuals with end-stage renal failure (ESRF). This study aimed to compare mortality in patients with ESRF versus the general population (GP) to assess the evolution of excess mortality by age, gender, nephropathy, and dialysis modality after first dialysis. All incident adult dialysis patients from January 1,1999, to December 31, 2003, who lived in RhneAlpes Region (France) were included and followed up to death or December 31, 2005. Standardized mortality ratios (SMR) in comparison with GP were computed in the first to the fifth years after first dialysis. In the whole cohort (3025 incident patients), SMR decreased during these 5 yr from 7.4 to 5.2 (P = 0.002). In the 18- to 44-, 45- to 64-, 65- to 74-, 75- to 84-, and 85-yr-old groups, SMR decreased from 26.7 to 6.2 (P = 0.01), from 12.8 to 8.1 (P = 0.03), from 8.6 to 5.6 (P = 0.051), from 7.1 to 4.5 (P = 0.02), and from 3.5 to 1.2 (P = 0.14), respectively. Among age categories, differences were significant in the first 3 yr (P < 0.05). SMR were higher 1.5-fold in women Continue reading >>

Men At Higher Risk For Type 2 Diabetes

Men At Higher Risk For Type 2 Diabetes

More than 100 million people worldwide have Type 2 diabetes, and in many parts of the world, men have higher rates of the condition than women. A recent study from the University of Glasgow in Scotland suggests a possible explanation for this: Men may be “biologically more susceptible” to the condition. In Type 2 diabetes, high blood glucose is caused mainly by a combination of two factors: insulin resistance, a condition in which the body does not use insulin efficiently, and insufficient insulin secretion by the pancreas. A variety of factors increase the risk of developing Type 2, such as being overweight or obese, storing fat in the abdomen (as opposed to in the hips or thighs), and being physically inactive. Age, race, family history, and a personal history of gestational diabetes or prediabetes also contribute to a person’s risk of developing Type 2 diabetes. To determine whether men and women develop diabetes at different average body-mass index (BMI, a measure of a person’s weight in relation to his height) levels, researchers from the university analyzed data from 43,137 women and 51,920 men with Type 2. They compared the participants’ BMI levels (recorded within one year of diagnosis) and also took into account other factors such as age and smoking rates. The data showed that the average BMI at diagnosis was 31.83 among men but 33.69 among women. The difference was most pronounced at younger ages. According to lead study author Naveed Sattar, MD, PhD, “Previous research has indicated that middle-aged men are at a higher risk of developing diabetes than women and one possible explanation is that men have to gain less weight than women to develop the condition. In other words, men appear to be at higher risk for diabetes.” Fat distribution may expl Continue reading >>

Gender And T2dm - Type 2 Diabetes Mellitus - Diapedia, The Living Textbook Of Diabetes

Gender And T2dm - Type 2 Diabetes Mellitus - Diapedia, The Living Textbook Of Diabetes

In the first half of the last century the prevalence of type 2 diabetes was higher among women than among men, but this trend has shifted, so more men than women are now diagnosed with type 2 diabetes . This change in the gender distribution of type 2 diabetes is mainly caused by a more sedentary lifestyle particularly among men, resulting in increased obesity. However, recent data have also shown that men develop diabetes at a lower degree of obesity than women a finding which adds support to the view that the pathogenesis of type 2 diabetes differs between men and women. Observations of sex differences in body fat distribution, insulin resistance, sex hormones, and blood glucose levels further support this notion. Figure 1: Cross-sectional abdominal magnetic resonance image of an obese woman and an obese man [1]. Obesity is one of the main risk factors for type 2 diabetes, and especially the abdominal visceral fat is associated with increased type 2 diabetes risk. Body fat distribution differs by sex [1] , and in general men have more abdominal fat, whereas women have more peripheral fat also denoted as apple versus pear shape. Looking into the abdominal fat, men also tend to have more visceral and hepatic fat than women, whereas women have more subcutaneous fat than men (Figure 1). In contrast to visceral fat, subcutaneous fat is associated with improved insulin sensitivity and is therefore protective against type 2 diabetes. Thus, the phenomenon that men develop diabetes at a lower body mass index than women [2] can be explained by the fact that men have more visceral fat for a given body mass index than women and thereby a higher relative risk for developing type 2 diabetes. Insulin resistance and blood glucose levels The sex differences in body fat distribution a Continue reading >>

Diabetes And Gender.

Diabetes And Gender.

Diabetes and Metabolism, Division of Medicine, University of Bristol, UK. It is often assumed that there is little or no sex bias within either Type I (insulin-dependent) or Type II (non-insulin-dependent) diabetes mellitus. This review considers evidence that sex effects of interest and importance are present in both forms of the disease. Type I diabetes is the only major organ-specific autoimmune disorder not to show a strong female bias. The overall sex ratio is roughly equal in children diagnosed under the age of 15 but while populations with the highest incidence all show male excess, the lowest risk populations studied, mostly of non-European origin, characteristically show a female bias. In contrast, male excess is a consistent finding in populations of European origin aged 15-40 years, with an approximate 3:2 male:female ratio. This ratio has remained constant in young adults over two or three generations in some populations. Further, fathers with Type I diabetes are more likely than affected mothers to transmit the condition to their offspring. Women of childbearing age are therefore less likely to develop Type I diabetes, and--should this occur--are less likely to transmit it to their offspring. Type II diabetes showed a pronounced female excess in the first half of the last century but is now equally prevalent among men and women in most populations, with some evidence of male preponderance in early middle age. Men seem more susceptible than women to the consequences of indolence and obesity, possibly due to differences in insulin sensitivity and regional fat deposition. Women are, however, more likely to transmit Type II diabetes to their offspring. Understanding these experiments of nature might suggest ways of influencing the early course of both forms of Continue reading >>

Gender Play – The Relationship Between Gender And Diabetes

Gender Play – The Relationship Between Gender And Diabetes

In a recently published study, it was revealed that while death rates fell for men between the years 1971 to 2000 with diabetes, the rates for women with diabetes did not fluctuate. Men with diabetes live 7.5 years less than other men who do not have diabetes. This number increases to 8.2 years among women who have diabetes to those who do not.1 However, in a very different study, researchers at the University of Glasgow revealed that men are biologically more susceptible to getting diagnosed with type 2 diabetes than women.2 What do these studies mean? How can a male or a female prevent themselves from being diagnosed with Type 2 diabetes? If you already have Type 2 diabetes, what can be learned from these studies in order to have a good diabetes management? Also, how does diabetes affect male versus female? In this article, we will look at some of the most prominent studies conducted in this area and ways of preventing/managing for an efficient diabetes management based on one’s gender. The earlier mentioned research from University of Glasgow indicates that men do not need to gain more weight than women to be diagnosed with Type 2 diabetes. This means that women have to gain considerable weight and fat, compared to males, in order to have fat deposits that are linked with diabetes. While women store most of their fat in the thigh and hip area, men tend to store their fat mostly in the waist and in their liver. The results of this research were drawn from 51, 920 men and 43, 173 women in Scotland. The BMI for a diagnosis in diabetes in men was 31.83 compared to 33.69 in women. We are now aware of several factors that are at play for the increase in chances of getting Type 2 diabetes: lifestyle age ethnicity body weight obesity socioeconomic status. This study confir Continue reading >>

Gender Differences In The Relationship Between Diabetes Process Of Care Indicators And Cardiovascular Outcomes

Gender Differences In The Relationship Between Diabetes Process Of Care Indicators And Cardiovascular Outcomes

Gender differences in the relationship between diabetes process of care indicators and cardiovascular outcomes 1 Laboratorio Management e Sanit, Istituto di Management, Scuola Superiore Sant'Anna, Pisa, Italy Search for other works by this author on: 2 Agenzia Regionale Sanit, Regione Toscana, Florence, Italy Search for other works by this author on: 2 Agenzia Regionale Sanit, Regione Toscana, Florence, Italy Search for other works by this author on: 2 Agenzia Regionale Sanit, Regione Toscana, Florence, Italy 3 Centre of Study for Gender Health, Azienda USL 3, Pistoia, Italy Search for other works by this author on: European Journal of Public Health, Volume 26, Issue 2, 1 April 2016, Pages 219224, Chiara Seghieri, Laura Policardo, Paolo Francesconi, Giuseppe Seghieri; Gender differences in the relationship between diabetes process of care indicators and cardiovascular outcomes, European Journal of Public Health, Volume 26, Issue 2, 1 April 2016, Pages 219224, Background: Adherence to recommended guidelines in the care for diabetes has been demonstrated to significantly prevent the excess risk of hospitalization and mortality for cardiovascular diseases. Aim of this study was to evaluate whether adherence to a standardized process quality-of-care-indicator in diabetes, is able to predict, equally in men and women, first hospitalization or mortality risk after acute myocardial infarction (AMI), ischemic stroke (IS), congestive heart failure (CHF), lower extremity amputations (LEA) or any of above major adverse cardiovascular events (MACE). Methods: Guideline composite indicator (GCI), a process indicator including one annual assessment of HbA1c and at least two among eye examination, serum lipids measurement and microalbuminuria, was measured in the year 2006 in 91 826 ( Continue reading >>

Knowledge Of Diabetes Mellitus: Does Gender Make A Difference? - Sciencedirect

Knowledge Of Diabetes Mellitus: Does Gender Make A Difference? - Sciencedirect

Volume 5, Issue 4 , August 2014, Pages 199-203 Knowledge of Diabetes Mellitus: Does Gender Make a Difference? Open Access funded by Korea Centers for Disease Control and Prevention Diabetes mellitus (DM) is a chronic disease considered an important public health problem. In recent years, its prevalence has been exponentially rising in many developing countries. Chronic complications of DM are important causes of morbidity and mortality among patients, which impair their health and quality of life. Knowledge on disease prevention, etiology, and management is essential to deal with parents, patients, and caregivers. The aim of this study was to evaluate the knowledge regarding DM in an adult population from a Middle-western Brazilian city. This was a cross-sectional study covering 178 adults, aged 1864 years, who answered a diabetes knowledge questionnaire. In order to identify the difference between groups, analysis of variance was used. Higher knowledge scores were found regarding the role of sugars on DM causality, diabetic foot care, and the effects of DM on patients (blindness, impaired wound healing, and male sexual dysfunction). However, lower scores were found amongst types of DM, hyperglycemic symptoms, and normal blood glucose levels. Females tended to achieve better knowledge scores than males. Women had better knowledge regarding types of DM, normal blood glucose values, and consequences of hyperglycemia revealed that diabetes education should be improved. Continue reading >>

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