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Gender And Outcomes in Type 2 Diabetes Mellitus 51
and Cardiovascular Disease

factors (5). These data add to the existing evidence 4. Anand SS, Islam S, Rosengren A, Franzosi MG, Steyn K, Yusufali AH, Kel-
that men and women experience diabetes-related tai M, Diaz R, Rangarajan S, Yusuf S; INTERHEART Investigators. Risk
diseases differently and suggest the need for further factors for myocardial infarction in women and men: insights from the
INTERHEART study. Eur Heart J. 2008 Apr;29(7):932-40.
work to clarify the biological, behavioral, or social
mechanisms involved. 5. Peters SA, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in
women compared with men: a systematic review and meta-analysis of 64
cohorts, including 775,385 individuals and 12,539 strokes. Lancet. 2014
Mortality Jun 7;383(9933):1973-80.
Presence of MetS was associated with a 2-fold high-
er risk of CVD and 1.5-fold increase of mortality, with
consistently higher risk for women than men, includ-
ing all-cause mortality. Diabetes is associated with an
almost 2-fold increased risk of death. The sex ratio
of risk of fatal CHD or stroke showed a greater risk
in women, which did not improve over time.

Future Perspective
Increased awareness of health professionals regard-
ing sex and gender differences in development and
management of T2DM and its complications is need-
ed. At present, there are some interesting studies to
show the risk factors, pathophysiology and complica-
tions of diabetes for both men and women and they
differ from each other in all categories. Randomized
controlled trials proving sex-specific effects by ad-
equately designed interventions are widely missing.
Another problem is the lack of a defined methodol-
ogy for sex- or gender-specific analysis.

Highlights
• Morbidity and mortality of women with diabetes
is much higher when compared to men
• Men are diagnosed with diabetes at a younger
age but obese women are prone to diabetes even
at younger age.
• Women with T2DM are generally under treated
for cardiovascular risk than men
• Future studies need to focus on gender based
management of T2DM and CVD

• Physicians need to have better understanding of
gender differences and CVD risks in T2DM

References
1. Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differences in risk,
pathophysiology and complications of type 2 diabetes mellitus. Endocrine
reviews. 2016 May 9;37(3):278-316.
2. The EUGenMed, Cardiovascular Clinical Study Group. Gender in cardio-
vascular diseases: impact on clinical manifestations, management, and
outcomes Eur Heart J. 2016 Jan 1;37(1):24-34.
3. Garawi F, Devries K, Thorogood N, Uauy R Eur J Clin Nutr. , Global dif-
ferences between women and men in the prevalence of obesity: is there
an association with gender inequality? Eur.Journal of Clinical Nutrition
68, 1101-1106

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