Statistically speaking, men are More likely than women to be diagnosed with type 2 diabetes, with about 18 million men suffering from the disease worldwide. This doesn’t tell the whole story. When women do get diagnosed, they are usually older and have higher body fat mass. They are also more likely to die from causes related to diabetes, especially heart disease. Some researchers believe that inadequate diagnosis may explain part of the gap—perhaps women missed more cases.
To address this discrepancy, researchers sought to learn more about the biological and social differences that helped later diagnosis and poor women’s outcomes, with some showing that it is time for healthcare providers to change the way they test diabetes in order to capture high-risk women earlier, while treatment and lifestyle changes may have a greater impact.
There are several potential reasons behind the differences in diagnosis between men and women. Although many of the risk factors for type 2 diabetes are common, they later tend to appear in women. The disease may also differ in women, which may cause current diagnostic tools to ignore them. Michael Leutner, professor of endocrinology and metabolism and a member of the gender medicine department of the Medical University of Vienna, said using some tests, but not others, is “the main reason for inadequate diagnosis for women.”
We know that there are biological differences among the genders that affect type 2 diabetes, especially the effects of hormones. Throughout a person’s life, major hormonal transformations affect how their body manages blood sugar, while life events such as pregnancy and menopause can affect the development and progress of type 2 diabetes.
Gestational diabetes during pregnancy “is one of the most powerful pioneers of what is about to happen,” said Judith Regginsteiner, director of the Ludeman Family Women’s Health Research Center at the University of Anschutze Medical Campus in Colorado. In fact, gestational diabetes diagnosis is the only biggest risk factor for women with type 2 diabetes, and some of these studies show that women who experience gestational diabetes are eight times more likely to develop type 2 diabetes later in life.
Other hormone changes in a woman can affect the risk and progression of type 2 diabetes during her lifetime. For example, how to store fat in the body is a key risk factor for type 2 diabetes in everyone, but not all fats are equal. At younger age, men are more likely to store visceral fat than women. “That’s belly fat deep in the abdomen,” explains Peter Goulden, an associate professor at Icahn Medical School.
Visceral fat is particularly harmful because it releases free fatty acids, which increases resistance to insulin – hormones that regulate blood sugar. Insulin “is the key to unlocking cells, so glucose can enter the cells,” Goulden said. With insulin resistance, the human body’s cells stop responding effectively to insulin, and glucose accumulates in the blood.
