Does diabetes have worse effects on women? -By Dr. Iheoma Durunguma

Diabetes mellitus is a metabolic disease characterised by a chronic rise in blood glucose levels. As with many other diseases, a myriad of biological factors influence its onset, progression and risk of complications or comorbidities. Such biological factors include age, family history, hormone levels, nutrition and gender. Today, our focus will be on the role gender plays in diabetes.

Research has shown that Type 1 diabetes has a greater prevalence in men than in women of the same age, and that men are more likely to pass the disease on to their offspring. Type 2 diabetes also shows a higher male prevalence especially in early middle age, while women are more likely to pass Type 2 diabetes onto their offspring.

Studies show that more men than women live with diabetes. Men are also more likely to be diagnosed with Type 2 diabetes than women, and so the onset of Type 2 diabetes is earlier in men than in women. One reason is that men store more fat in their bellies—a known risk factor. Also, more men than women have diabetes that’s undiagnosed; perhaps because they feel it is “better to not know” or “something must kill a man” or “don’t want to hear bad news.” A man with obesity is more likely to suffer the risks of obesity (diabetes, hypertension) than his female counterpart of similar Body Mass Index because of the differences in insulin sensitivity in men and women.

Insulin sensitivity patterns differ in men and women. For the benefit of the reader, insulin sensitivity is the rate at which the body cells use insulin and respond to it. A high insulin sensitivity means that body cells respond effectively to insulin and take up glucose from the blood. On the other hand, a low insulin sensitivity means a low response to insulin, leaving glucose in the blood and increasing the risk for hyperglycemia (high glucose levels), and consequently, diabetes.

Insulin sensitivity is influenced by factors such as fat deposition, hormones, and lifestyle choices. The difference between insulin sensitivity in men and women is however based on fat deposition and hormones. Men tend to have more fat deposited on their internal organs especially the ones in the abdomen(liver; pancreas), which is why they appear to be leaner, while women tend to have more fat deposited in subcutaneous tissues and peripherally, on their bodies, manifesting as a more bulky body mass.

Complications from diabetes arise due to several reasons: poor glycaemic control, sedentary lifestyle practices coupled with alcohol intake, smoking and non-compliance with a healthy dietary regimen.  Common organs affected include the kidneys, heart, brain, eyes and extremities (hand and feet).

Although men are at higher risk of becoming diabetic (due to lifestyle choices and visceral fat mass), studies have shown that women are more likely to suffer from the complications of diabetes. This is probably because high levels of glucose in the blood blunt the protective effect of oestrogen, the female hormone which has a role in protecting the body from insulin resistance.

The risk of diabetic complications in women also increases rapidly as they age due to menopause. In menopause, oestrogen levels reduce drastically, leaving women bare to the effects of hyperglycaemia and putting them at risk of diabetic complications such as stroke, pain in the arms and legs due to blocked arteries, vascular diseases, kidney diseases and heart diseases.

Heart and vascular diseases especially have been reported to affect women much more than they affect men, even becoming more lethal in women when compared to men. The reasons for the higher impact of heart diseases due to diabetes on women are not completely clear. However, some postulations say this occurs because women are more resistant or unresponsive to the effect of the drugs prescribed for their heart problems than men are.

Depression, which is more likely to occur in women than in men, also increases the chances of worsening diabetes by about 50%; further impacting the rate at which women tend to be affected by diabetes and develop diabetic complications.

Although the data mostly suggest that women are affected by diabetes more than men, another set of lifestyle factors come to play. Women are reportedly more meticulously concerned about their health than men; they tend to follow through with the doctor’s guidelines and indulge less in drinking alcohol and smoking.  This presents another dynamic as it is well known that poor glycaemic control, alcohol intake and smoking worsen the effect of diabetes, and increase the risk of diabetic complications.

However, whether male or female, it is important to work with a healthcare professional to ensure that your glucose levels are controlled. Adhering to beneficial lifestyle adjustments also helps to reduce the impact of diabetes on your health.

• Dr Iheoma Durunguma, member of LiveWell Club, can be reached on 08039455666