Poorer control of risk factors is the likely culprit.
Diabetic men are more likely to experience kidney and lower limb complications as well as cardiovascular ones than women with diabetes, an Australian study suggests.
New Australian research published in the Journal of Epidemiology and Community Health suggests men with diabetes are 47% more likely to experience a lower limb complication and 55% more likely to experience a kidney complication, but 6% less likely to experience an eye complication than women.
“[This study] is a good reminder that focusing on a broad range of risk factors for complications of diabetes is likely to reduce the risk of complications developing,” said Professor Jonathan Shaw, deputy director of clinical and population health at the Baker Heart and Diabetes Institute in Melbourne.
Researchers from the University of Sydney analysed data the 45 and Up Study and administrative health records for over 25,000 diabetic Australians to compare potential sex differences in broad (e.g., cardiovascular, eye, kidney and lower limb) and specific (e.g., stroke, cataracts, peripheral neuropathy and chronic kidney disease) groups of complications.
Diabetic men were at greater risk of developing any cardiovascular, lower limb and kidney complication compared to women, but had a lower risk of eye complications after the researchers controlled for factors such as age, socioeconomic status, private health insurance status, BMI, smoking and physical activity.
When specific complications were considered, men were 39% more likely to have a stroke, 101% more likely to develop diabetic cardiomyopathy, 38% more likely to develop peripheral neuropathy, 156% more likely to require a lower limb amputation, 70% more likely to develop chronic kidney failure, and 113% more likely to require dialysis.
Men were 10% less likely to develop cataracts but 14% more likely to develop diabetic retinopathy.
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How long someone had been living with diabetes had limited effects on the sex-specific estimates of experiencing a complication.
Professor Shaw told TMR there was a relatively simple explanation for the sex-specific differences.
“[The differences are] likely mainly due to worse risk factor control (e.g., blood pressure, lipids), and possibly due to less engagement with health services among men,” he said.
The study was limited by the fact it was unable to control for factors such as glycaemic, lipid or blood pressure control or medication usage, nor were they able to distinguish between people living with type 1 and type 2 diabetes.
The Australian Institute for Health and Welfare estimates one in 20 Australians lives with diagnosed diabetes, most of whom have type 2 diabetes.
Journal of Epidemiology & Community Health 2024, online 16 May
