Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA.
Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Diabetologia. 2019 Oct;62(10):1761-1772. doi: 10.1007/s00125-019-4939-5. Epub 2019 Aug 27.
By 2017 estimates, diabetes mellitus affects 425 million people globally; approximately 90-95% of these have type 2 diabetes. This narrative review highlights two domains of sex differences related to the burden of type 2 diabetes across the life span: sex differences in the prevalence and incidence of type 2 diabetes, and sex differences in the cardiovascular burden conferred by type 2 diabetes. In the presence of type 2 diabetes, the difference in the absolute rates of cardiovascular disease (CVD) between men and women lessens, albeit remaining higher in men. Large-scale observational studies suggest that type 2 diabetes confers 25-50% greater excess risk of incident CVD in women compared with men. Physiological and behavioural mechanisms that may underpin both the observed sex differences in the prevalence of type 2 diabetes and the associated cardiovascular burden are discussed in this review. Gender differences in social behavioural norms and disparities in provider-level treatment patterns are also highlighted, but not described in detail. We conclude by discussing research gaps in this area that are worthy of further investigation.
根据 2017 年的估计，全球有 4.25 亿人患有糖尿病；其中约 90-95%为 2 型糖尿病。本综述重点介绍了与整个生命周期 2 型糖尿病负担相关的两个性别差异领域：2 型糖尿病患病率和发病率的性别差异，以及 2 型糖尿病带来的心血管负担的性别差异。在存在 2 型糖尿病的情况下，男性和女性心血管疾病 (CVD) 的绝对发病率差异会缩小，但男性的发病率仍然更高。大规模观察性研究表明，与男性相比，女性发生 CVD 的风险增加 25-50%。本综述讨论了可能导致观察到的 2 型糖尿病患病率和相关心血管负担性别差异的生理和行为机制。本文还强调了社会行为规范中的性别差异和提供者层面的治疗模式差异，但未详细描述。最后，我们讨论了该领域值得进一步研究的研究空白。
