Causes, treatments, management… Research is progressing in the field of diabetes. As part of a new series devoted to this disease, Why Doctor has collected the words of Professor Pierre Gourdy, endocrinologist and metabolism doctor (Institut Cardiomet / CHU of Toulouse), to understand how diabetes affects men and women differently.
- More than 4.5 million people in France have diabetes, but about 1 million of them are unaware of it.
- Diabetes is “one of the world’s leading killers”, along with high blood pressure and smoking, according to the World Health Organization (WHO).
“Epidemiological data show the existence of differences between women and men with regard to susceptibility to diabetes and some of its complications”, explained Professor Pierre Gourdy, endocrinologist and metabolism doctor at the last congress of the Francophone Diabetes Society (SFD).
The prevalence of diabetes is higher in men
Figures show that the prevalence of diabetes is higher among men in many parts of the world. In France, several recent data confirm this male predominance. First of all, data from the National Health Insurance Inter-regime Information System (Sniiram) showed, in 2015, a higher prevalence of pharmacologically treated diabetes in men (6.1%) than in men. women (4.2%), with the same age structure.
On the other hand, data from the National Health Data System (SNDS) have made it possible to establish, in the adult population aged 45 and over, a prevalence of diabetes equal to 12.1% in men, against 8 .4% in women. Finally, a recent study confirms that this male predominance also applies to situations of undiagnosed diabetes (2.7% in men and 0.9% in women) and pre-diabetes (13.2% in men and 7% in women).
More complications in women
“Differences are also observed in terms of the risk of complications”, continues Pierre Gourdy. If we know that diabetes increases the risk of presenting a cardiovascular event (myocardial infarction or stroke) in both sexes, this impact is more marked in women (risk multiplied by 3) than in men (multiplication by 2). “Diabetes therefore seems to partially erase the female protection observed before menopause (beneficial effect of estrogens) against these cardiovascular attacks”, emphasizes the Professor. “However, some complications such as chronic kidney disease (diabetic nephropathy) or trophic disorders (foot sores) are more common in men than in women.” he adds.
In favor of gender-appropriate medicine
Most national and international bodies, including the National Institutes of Health (NIH) in the United States, strongly encourage research efforts aimed at better understanding these gender and biological sex differences. In France, the Academy of Medicine also positioned itself, in June 2016, in favor of medicine adapted to the sex of patients. “In current approaches aimed at precision medicine, this is indeed a major challenge for proposing more individualized diabetes prevention and management strategies adapted to the sexual context”, Judge Pierre Gourdy.
And to conclude: “to advance in understanding these differences between women and men, it is important to distinguish the influence of sex, which encompasses all biological aspects, from that of gender, which concerns behavioral and societal aspects”.
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