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Men Are at Greater Risk Than Women of Diabetes Complications Like Stroke

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Author : Becky Upham
Update time : 2024-05-28 09:08:38
Men are at greater risk than women for major health complications of both type 1 and type 2 diabetes, according to a long-term study published on May 16 in the Journal of Epidemiology & Community Health.

Men with diabetes had up to a 50 percent higher risk of heart disease and stroke, leg and foot complications (including numbness called neuropathy, and in extreme cases, amputations), kidney complications, and diabetic retinopathy, says Emma Cox, a PhD candidate at the Charles Perkins Center at the University of Sydney and a coauthor of the study.

“Complication rates increased with the duration of diabetes, yet the disparity between men and women remained consistent. This highlights the need for complication screening and prevention strategies from the time of diabetes diagnosis,” says Cox.

It’s estimated that about 38 million people in the United States have diabetes, which is 11.6 percent of the population. The percentage of men and women with both diagnosed and undiagnosed diabetes is close to the same: 20 million men compared with 18 million women.

Study Followed 25,000 People for 10 Years to Track Diabetes Complications

To explore the prevalence of diabetes complications and how it relates to gender, researchers used survey responses from the Australian 45 and Up Study, a large prospective study of more than 250,000 people aged 45 and older in New South Wales. By connecting respondents to their medical records, the researchers determine about 10 percent of participants had either type 1 or type 2 diabetes. 

Over a 10-year period, researchers monitored study subjects with diabetes to see if they developed any of the major health issues associated with the condition, including heart disease, eye problems like cataracts and diabetic retinopathy, nerve damage, minor or major amputations, and kidney issues.

Men With Diabetes Were More Than 50 Percent Likelier to Develop Cardiovascular Disease Than Women

After adjusting for age, researchers found men were 51 percent more likely to develop cardiovascular disease than women, 47 percent more likely to have leg and foot complications, 55 percent more likely to have kidney complications, and 14 percent more likely to have diabetic retinopathy.

In both men and women, the risk of complications rose according to the number of years they had lived with diabetes, but the risk for men continued to be higher.

“While the rates of complications are slightly lower amongst women, it is still important to note that rates of complications are very high in both sexes,” says the lead author, Alice , PhD, a researcher at the Charles Perkins Center.

These figures also only reflect those without complications at the beginning of the study, and don't account for people who had preexisting complications or multiple complications. That means the overall burden of complications in people with diabetes is likely much higher than what this study found, adds Dr. .

Individualized, Comprehensive Care Is Needed for People With Diabetes

“The biggest takeaway is that diabetes significantly increases the risk of complications, and that to reduce the risk of micro and macrovascular complications, we need individualized and comprehensive care,” says Marilyn Tan, MD, an associate professor of medicine and an endocrinologist at Stanford Health Care in California who was not involved in the study. 

The study noted quite significant gender differences in the risk of diabetes complications, but it’s important to keep in mind that some major risk factors weren’t included in the research, says Dr. Tan.

“Critically, this study did not take into account glycemic control, lipid control, blood pressure control, and use of medications, including those which may increase or decrease cardiovascular risk,” she says.

The authors acknowledged those missing factors are a limitation of the study, as well as the omission of people with a history of complications.

The findings are also limited because of the type of data used, says Tan. Many complications of diabetes are manifested in ways that don't necessarily show up on hospitalization claims, and this study would miss those, she says.

Men May Be Less Likely to Take Medications or Get Regular Health Checks

The authors offer a few theories on why the risks for men and women are different. For starters, in this study, the men in the study were about 50 percent more likely to have preexisting heart disease, says Alice.

It’s likely that the men in the United States would have similar increased risks, says Alice.

Men in both countries may be less likely to make lifestyle changes, take preventive meds, or get health checks to lower their risks, she says.

“Studies from both countries have shown that men are more likely to have high blood pressure and cholesterol, poor diabetes control, be overweight, and to smoke, which are well known risk factors for complications of diabetes,” says Alice.

There are also protective factors in women such as breastfeeding and the use of hormone replacement therapy which may have contributed to the sex differences, says Alice.

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