Gender Differences in Diabetes

Lifestyle is a huge risk factor. Smoking, lack of activity, and poor diet all increase the risk of diabetes, but one key difference is weight. 

Men are usually diagnosed with diabetes at a lower weight or body mass index (BMI) than women. This may be due to women carrying fat tissue in different areas and maintaining healthy metabolic rates despite obesity.³ 

Women who are diagnosed with type 2 diabetes are at higher risk of experiencing diabetes-related complications, such as:⁴ 

• heart disease, 
• vision loss, 
• kidney disease and
• Depression

In fact, the risk of heart disease increases twofold for women with diabetes compared to their male counterparts.⁵ Women with diabetes also have worse outcomes after heart attacks. They’re often less likely to recognize the signs of a heart attack or delay treatment –– making it more difficult to recover. 

When it comes to men who are diagnosed with diabetes, they are at higher risk of experiencing diabetes-related complications, such as:⁶

• Diabetic retinopathy
• Osteomyelitis (inflammation or swelling that occurs in the bone) and/or amputation of the lower limbs (toes, feet, and legs)
• kidney failure, chronic kidney disease and dialysis

In fact, regardless of the prevalence of diabetes being relatively similar in men and women worldwide, studies have found that men with foot complications caused by diabetes have an approximate 50% increased amputation risk compared to women.⁶

Certain conditions that only occur in women can be additional risk factors for diabetes. For example, polycystic ovary syndrome –– a hormonal disorder that causes enlarged ovaries and cysts –– increases the chances of developing type 2 diabetes.⁷ 

Similarly, gestational diabetes is a type of diabetes that develops during pregnancy. Although it usually ends after pregnancy, gestational diabetes puts women at a higher likelihood of developing type 2 diabetes in the future. 

Additional issues women often experience include: 

1. Urinary Tract and Yeast Infections — High blood sugar levels may be responsible for increasing the risk. To prevent yeast and urinary tract infections, work to keep blood sugar levels in your target range. Drinking plenty of water, urinating often, and wearing cotton underwear can help, too. 
2. Menstrual Cycle Changes — Hormone levels change before and during your period. These changes can make it difficult to predict blood sugar levels. Check blood sugar often and track results to see if you find a pattern. Talk to your healthcare provider about taking more insulin if needed during the days before your period. 
3. Birth Control — If you don’t want to become pregnant or you want to ensure your blood sugar levels are in your target range first, talk to your doctor about birth control. Your physician can help you determine which option is right for you. 
4. Menopause — As the body makes less estrogen, you could experience more ups and downs in blood sugar levels during menopause. Hot flashes or weight gain could make managing your blood sugar more difficult. Discuss your symptoms with your doctor and work with your care team to determine the best care plan for you. 

Diabetes affects reproductive and sexual health in both men and women. And studies show that more than 78% of women who have type 2 diabetes report some type of sexual dysfunction.⁸ 

Common forms of sexual dysfunction reported in women with diabetes include: 

• Low sexual satisfaction 
• Lower sex drive 
• Vaginal dryness, which may lead to painful or uncomfortable sex 
• Difficulty being aroused 
• Difficulty achieving orgasm 

Common forms of sexual dysfunction reported in men with diabetes include: ⁹

• Erectile dysfunction (ED)
• Low testosterone 
• Low sex drive
• Difficulty achieving orgasm
• Peyronie’s disease, which can lead to painful or uncomfortable sex

Gender differences in diabetes do exist, but  it’s important to be proactive about your health no matter your gender. Focus on living a healthy lifestyle and working with your care team to manage your diabetes. Get active, eat a healthy diet, and follow your treatment plan. This will help reduce the risk of diabetes-related complications. 

¹Kautzky-Willer, Alexandra et al. “Sex differences in type 2 diabetes.” Diabetologia vol. 66,6 (2023): 986-1002. doi:10.1007/s00125-023-05891-x Accessed August 09, 2024

²Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278-316. doi:10.1210/er.2015-1137 Accessed August 09, 2024

³Logue J, Walker JJ, Colhoun HM, et al. Do men develop type 2 diabetes at lower body mass indices than women?. Diabetologia. 2011;54(12):3003-3006. doi:10.1007/s00125-011-2313-3 Accessed August 09, 2024

⁴U.S Centers for Disease Control and Prevention. Diabetes and Women. Available at: https://www.cdc.gov/diabetes/risk-factors/diabetes-and-women-1.html Accessed August 09, 2024.

⁵American Heart Association. Why are women with diabetes at greater risk for poor heart health? Available at: https://www.heart.org/en/news/2019/05/14/why-are-women-with-diabetes-at-greater... Accessed August 09, 2024.

⁶Gibson, A. A., et al. (2024). Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes. Journal of Epidemiology and Community Health. doi.org/10.1136/jech-2023-221759. Accessed August 09, 2024

⁷U.S Centers for Disease Control and Prevention. Diabetes and Polycystic Ovary Syndrome (PCOS). Available at: https://www.cdc.gov/diabetes/risk-factors/pcos-polycystic-ovary-syndrome.html Accessed August 09, 2024.

⁸Elyasi F, Kashi Z, Tasfieh B, Bahar A, Khademloo M. Sexual dysfunction in women with type 2 diabetes mellitus. Iran J Med Sci. 2015;40(3):206-213. PMID: 25999619 Accessed August 09, 2024

⁹American Diabetes Association. Sex and Diabetes. Available at: https://diabetes.org/health-wellness/sexual-health/sex-diabetes Accessed August 09, 2024.

Siddiqui MA, Khan MF, Carline TE. Gender differences in living with diabetes mellitus. Mater Sociomed. 2013;25(2):140-142. doi:10.5455/msm.2013.25.140-142 Accessed August 09, 2024