The Role of Gender in the Onset, Development and Impact of Type 2 Diabetes Mellitus and Its Co-Morbidities

Almost half a billion people worldwide are living with diabetes mellitus (DM). Complications associated with DM are common and approximately half of those people with DM suffer from at least one comorbidity. There is high mortality, morbidity and cost associated with these comorbidities which include cardiovascular disease, retinopathy, nephropathy, neuropathy and osteopathy. Gender influences the relative risk of developing complications from DM via differing mechanisms – both directly and indirectly. Generally, an increased relative risk of cardiovascular disease and kidney disease is noticed in women with DM compared to the non-DM context, where rates of both are much higher in men. Men appear to be at greater risk of diabetic retinopathy and also of insensate diabetic neuropathy, whereas women suffer from an increased rate of painful diabetic neuropathy compared to men. These differences are not clear cut and vary regionally and temporally, indicating that the field would benefit from further research on both the epidemiology and physiological mechanism of the observed patterns. These differences should be taken into account in treatment programmes for DM and its comorbidities.