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Men with diabetes are at up to a 50% higher risk of heart disease, stroke, leg and foot complications (including numbness called neuropathy and, in extreme cases, amputation), kidney complications and diabetic retinopathy. Emma Cox, PhD student He is a research fellow at the Charles Perkins Centre at the University of Sydney and a co-author on the study.
“Complication rates increased with diabetes duration, but the gender gap remained constant. This highlights the need for screening for complications and prevention strategies starting from the time of diabetes diagnosis,” Cox said.
A 10-year study of 25,000 people to track diabetes complications
To explore the prevalence of diabetes complications and how it relates to gender, the researchers used survey responses from the Australian Over 45s Study, a large prospective study of more than 250,000 people aged 45 and over in New South Wales. By linking respondents to their medical records, the researchers found that approximately 10% of participants had type 1 or type 2 diabetes.
Over a 10-year period, the researchers monitored the diabetic subjects to see if they developed any of the major health problems associated with diabetes, including heart disease, eye diseases such as cataracts and diabetic retinopathy, nerve damage, minor or major amputations, and kidney disease.
Men with diabetes are over 50% more likely to develop cardiovascular disease than women
The researchers found that after adjusting for age, men were 51% more likely than women to develop cardiovascular disease, 47% more likely to develop leg and foot complications, 55% more likely to develop kidney complications, and 14% more likely to develop diabetic retinopathy.
For both men and women, the risk of complications increased with the number of years they had diabetes, but men remained at higher risk.
“It is important to note that although the incidence of complications was slightly lower in women, the incidence of complications was very high in both sexes,” the lead author wrote. Dr. Alice GibsonResearch Fellow at the Charles Perkins Center.
These figures also only represent people who were free of complications at the start of the study and do not take into account people who had pre-existing or multiple complications, meaning the overall burden of complications in people with diabetes is likely much higher than this study found, Dr Gibson added.
Diabetics Need Comprehensive, Personalized Care
“Most importantly, diabetes significantly increases the risk of complications and requires comprehensive, individualized care to reduce the risk of small and large vascular complications.” Marilyn Tan, MDAn endocrinologist and associate professor of medicine at Stanford Health Care in California, he was not involved in the study.
Although the study points to some sizable gender differences in risk of diabetes complications, it's important to remember that several key risk factors were not included in the study, Dr. Tan said.
“Importantly, this study did not take into account glycemic control, lipid control, blood pressure control, and the use of medications, including those that may increase or decrease cardiovascular risk,” she said.
The authors acknowledged that these missing factors, as well as the exclusion of people with a history of comorbid conditions, were limitations of their study.
Tang said the findings were also limited by the type of data used: Many diabetes complications manifest in ways that don't always show up on hospital claims, so the study would likely miss them, he said.
Men may be less likely to take medication or get regular medical checkups
The authors offer several theories about why men and women's risks differ: First, in this study, the men studied were about 50 percent more likely to have pre-existing heart disease, Gibson says.
Men in the United States likely face a similar increased risk, Gibson said.
Men in both countries may be less likely to make lifestyle changes, take preventive medications or get health checks to lower their risk, she says.
“Studies from both countries have shown that men are more likely to have high blood pressure, cholesterol, poorly controlled diabetes, be overweight and smoke – well-known risk factors for diabetes complications,” Gibson said.
Gibson said women also have protective factors, such as breastfeeding and use of hormone replacement therapy, that could contribute to the gender difference.
