Type 2 diabetes can lead to very different health problems in men and women, with a new study finding that the disease is more strongly linked to heart and kidney complications in men, while women face a higher risk of mental health problems after diagnosis.
The study followed 28,720 people newly diagnosed with type 2 diabetes in the UK and examined how different health conditions developed over time. Researchers tracked hypertension, cardiovascular disease, end-stage renal disease and mental health conditions using linked healthcare records.
The participants were followed for a median of 6.8 years, offering researchers a long-term view of how diabetes affected the two sexes differently.
Women face greater mental health risks
One of the clearest differences was seen in mental health.
Women with type 2 diabetes were more likely than men to later be diagnosed with conditions such as anxiety, depression and somatoform disorders.
Such mental health conditions were recorded in 8.1% of women, compared with 5.3% of men.
The study also found that women with diabetes may face greater risks involving memory, thinking and other mental health-related problems.
However, experts cautioned that these conditions cannot necessarily be blamed on diabetes alone. Cognitive and neuropsychiatric problems are generally more common among women, meaning several factors may contribute to the difference.
Doctors were therefore advised to remain alert to mental health and cognitive problems while treating women with diabetes.
Men face greater heart and kidney risks
For men, the pattern was different.
Men with type 2 diabetes were more likely to develop cardiovascular disease or end-stage renal disease than women.
Overall, 8.4% of men followed this health trajectory, compared with 5.3% of women.
The study also found that men generally developed complications earlier, while women tended to experience these events later.
Another important finding was related to mortality. People who developed a mental health condition after diabetes were found to die earlier.
Among people following the same disease trajectory, men died on average nine years younger than women.
High blood pressure was the most common complication
Hypertension, or high blood pressure, emerged as the most common complication after type 2 diabetes across different age groups and in both men and women. It affected 21.1% of men and 20.2% of women.
Although the overall difference between men and women was relatively small, the timing of complications differed, with men generally experiencing health events earlier.
Diabetes may affect men and women at different stages
Senior endocrinologist Prof Ravinder Goswami of the All India Institutes of Medical Sciences said diabetes can affect men and women differently.
Men may develop diabetes at a younger age. Women with diabetes, meanwhile, can lose the natural protection against heart disease that is usually seen before menopause.
The findings suggest that diabetes care cannot always follow exactly the same approach for every patient. Doctors may need to pay attention to different risks depending on whether the patient is a man or a woman.
Women used healthcare services more often
Despite women showing a higher rate of mental health conditions in the study, they also had higher average healthcare utilisation and more long-term prescriptions than men.
Researchers noted that lower use of healthcare services among men in the high-risk mental health group could point to gaps in their engagement with healthcare.
This difference may be important because people who develop additional health problems after diabetes need continued medical attention and monitoring.
What the findings mean
The study highlights that type 2 diabetes is not simply a disease that affects blood sugar. Over time, it can be linked with several other health problems, and the pattern may differ between men and women.
For men, greater attention may be needed for heart and kidney complications, while women may require closer monitoring for mental health and cognitive problems.
At the same time, the findings show the importance of looking beyond diabetes itself. Mental health conditions, healthcare use and the timing of complications all form part of a patient’s wider health journey.
The study’s findings therefore point towards a more individual approach to diabetes care, where doctors consider not only blood sugar levels but also the different health risks that may emerge in men and women over the years.
Study points to more personalised diabetes care
The findings point to the need for sex-specific diabetes care, with doctors paying attention to the different risks seen in men and women. The researchers suggested routine mental health screening, particularly for younger women, along with earlier cardiovascular and kidney monitoring for men.
They also noted that studying the sequence and timing of complications could help doctors identify patients at higher risk and intervene earlier.
However, the researchers cautioned that the study was observational, meaning it can show an association but cannot prove that diabetes directly caused the health conditions observed. The differences in mental health diagnoses may also partly reflect differences in healthcare-seeking behaviour between men and women.
Overall, the findings suggest that diabetes management may need to look beyond blood sugar control and consider the different health risks that men and women may face over time.
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