Kautzky-Willer Alexandra, Harreiter Jürgen
Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Gender Medicine Institute, Gars am Kamp, Austria.
Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Diabetes Res Clin Pract. 2017 Sep;131:230-241. doi: 10.1016/j.diabres.2017.07.012. Epub 2017 Jul 13.
Clinical guidelines for the management of type 2 diabetes recommend individual therapy considering age, duration of disease, presence of complication and risk of hypoglycaemia. However, at present, the patient's sex has no impact on clinical decisions. Yet, there is mounting data pointing at biological and psychosocial differences between men and women with great impact on progression of disease and complications. Moreover, choices and preferences of therapeutic strategies as well as adherence to lifestyle and pharmacological interventions differ in both sexes. In addition, drug therapy may have sex-specific side effects. Therefore, there is need of more research on biological differences and of evidence-based individualised targeted sex-sensitive therapeutic concepts. Clinical guidelines must consider relevant sex-differences. Development and implementation of sex-specific programs may help to improve adherence to therapy and to reduce progression of disease and development of complications. A more gender-sensitive clinical approach may improve quality of life and increase health and life expectancy in men and women with type 2 diabetes.
2型糖尿病管理临床指南建议根据年龄、病程、并发症情况和低血糖风险进行个体化治疗。然而，目前患者的性别对临床决策没有影响。然而，越来越多的数据表明，男性和女性在生物学和心理社会方面存在差异，这对疾病进展和并发症有很大影响。此外，两性在治疗策略的选择和偏好以及对生活方式和药物干预的依从性方面也有所不同。此外，药物治疗可能有性别特异性副作用。因此，需要更多关于生物学差异的研究以及基于证据的个体化针对性别敏感的治疗理念。临床指南必须考虑相关的性别差异。制定和实施针对性别的项目可能有助于提高治疗依从性，减少疾病进展和并发症的发生。一种对性别更敏感的临床方法可能会改善2型糖尿病男性和女性的生活质量，增进健康并延长预期寿命。
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