Men and women differ in their health trajectories after being diagnosed with type 2 diabetes (T2D), research shows, with each sex vulnerable to different conditions
The findings, in PLOS Medicine, suggest that strategies for diabetes prevention and management should be tailored according to sex in order to take advantage of valuable opportunities for early intervention
The study of nearly 29,000 people showed that women were more likely to experience mental health conditions after diagnosis, whereas men had a greater likelihood of cardio-renal complications afterwards
Health repercussions also tended to arrive sooner for men than for women
The researchers from Queen Mary University of London suggest that healthcare interventions for diabetes should therefore differ according to characteristics such as sex and age
“One of the clearest signals in our data was the sex difference,” reported Fabiola Eto, PhD, and colleagues
“Younger women with type 2 diabetes were showing mental health complications earlier and more often than we expected, which suggests routine psychological screening should be incorporated into standard diabetes care
“For men, the pattern looked different: cardiovascular and kidney risks tended to emerge earlier, pointing to a need for earlier monitoring and stronger strategies to support men’s engagement with their treatment over time.”
The team studied the health records of nearly 28,720 people diagnosed with T2D between 2010 and 2020
Using a statistical method called multi-state modeling, they traced the order, timing and combination of conditions that each person developed after their diabetes diagnosis
During a median of 6.8 years of follow up, 39% of the group experienced at least one significant health event following the onset of diabetes
The researchers found that women were more likely to be diagnosed with anxiety, depression, or somatoform disorder, a psychological condition in which there are physical symptoms without a clear physical cause. Collectively, these mental health conditions presented in 8.1% of women versus 5.3% of men
Women were also more likely to experience health trajectories that ended in death
Conversely, men were more likely than women to be diagnosed with cardiovascular disease or kidney failure, at a corresponding 8.4% versus 5.3%
Hypertension was the most common complication for both sexes, across almost all age groups except for the youngest women
“These findings indicate that knowing a complication is likely to occur is not enough; knowing when complications tend to occur and in what order may help translate population-level evidence into more targeted clinical action,” the authors reported
“Routine mental health screening should be incorporated in T2D care practice—particularly for younger women—while earlier cardiovascular and kidney disease monitoring and stronger healthcare engagement strategies are needed for men.”
They added: “Our results raise the hypothesis that the combination of T2D and mental health conditions may represent a high-risk group associated with premature death and high healthcare use, pointing to an urgent need for integrated physical and mental healthcare pathways.”
News & FeaturesAnxietyCardiovascular diseasesDepressive disorderDiabetesHypertensionKidney damageMental health servicesStatistical analysis
