Type 2 Diabetes Risks Differ in Men and Women, Study Finds

Type 2 diabetes may affect men and women differently, with a new study finding that the complications developing after diagnosis can vary in both timing and type.

Researchers found that men with type 2 diabetes were more likely to develop cardiovascular disease or end-stage renal disease, while women were more likely to develop mental health conditions including anxiety, depression and somatoform disorders.

Published in PLOS Medicine, the study followed 28,720 people newly diagnosed with type 2 diabetes between 2010 and 2020. Researchers used linked healthcare records from the UK and followed participants for a median of 6.8 years.

Instead of studying complications separately, the researchers used a multistate analysis to examine the sequence and timing of hypertension, cardiovascular disease, end-stage renal disease and mental health conditions following a diabetes diagnosis.

Women face higher mental health risks

Mental health conditions were recorded in 8.1% of women compared with 5.3% of men in the study.

Women with type 2 diabetes were more likely to develop anxiety, depression and somatoform disorders after their diagnosis. The researchers said the findings highlight the importance of including mental health in long-term diabetes monitoring, particularly for women.

However, the study was observational, so the results show associations rather than proving that diabetes directly caused the differences.

Men show greater heart and kidney risks

Men were more likely to follow a disease trajectory involving cardiovascular disease or end-stage renal disease. About 8.4% of men followed this trajectory, compared with 5.3% of women.

Men also generally developed complications earlier, while women tended to experience complications later.

The findings suggest that monitoring priorities could potentially differ between men and women, with earlier cardiovascular and kidney assessments potentially being particularly important for men with type 2 diabetes.

High blood pressure remains the most common complication

Hypertension was the most common complication identified across age groups and both sexes.

It affected 21.1% of men and 20.2% of women in the study, highlighting the importance of monitoring blood pressure alongside blood glucose in people living with type 2 diabetes.

Mental health linked to higher mortality risk

The researchers also examined mortality across different disease trajectories. People who developed mental health conditions after their diabetes diagnosis had a higher risk of earlier death.

Among people following the same high-risk mental health trajectory, men died on average nine years younger than women.

The study also found that women had higher average healthcare utilisation and long-term prescribing. Researchers suggested that lower healthcare use among men in the high-risk mental health group could reflect differences in engagement with healthcare services.

Earlier, targeted monitoring may help

The researchers said examining how and when complications develop could help doctors identify high-risk patients earlier.

The findings point towards the potential value of more tailored diabetes care. Women may benefit from closer attention to mental health, while men may require particularly careful monitoring for cardiovascular and kidney complications.

However, healthcare-seeking behaviour and differences in diagnosis could partly explain some of the observed differences, particularly the higher rate of recorded mental health conditions among women.

Overall, the study suggests that the long-term health risks associated with type 2 diabetes may follow different patterns in men and women. Recognising these differences could help healthcare providers detect complications earlier and tailor long-term monitoring more effectively.