Sex Differences in Cardiovascular Risk Associated with Type 2 Diabetes
Summary
Type 2 diabetes markedly elevates the risk of cardiovascular disease (CVD) in both men and women, yet women experience a greater relative increase in CVD outcomes once diabetes develops. This disparity emerges from a complex interplay of biological, behavioural and healthcare factors. Biologically, women with diabetes tend to exhibit a higher burden of adverse lipid profiles, greater central adiposity and more pronounced endothelial dysfunction than men at comparable stages of glycaemic impairment. Reproductive influences, including pregnancy‐related glucose intolerance and menopause, further amplify women’s cardiometabolic vulnerability. Behavioural factors such as delayed diagnosis, lower uptake of evidence-based preventive therapies and differences in health-seeking behaviour can exacerbate this gap. Although absolute rates of events remain higher in men, the proportional impact of diabetes on stroke, coronary heart disease and heart failure is notably larger in women, underlining an urgent need for sex-sensitive risk assessment, earlier intervention and tailored therapeutic strategies to narrow this excess risk.
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Sex Differences in Cardiovascular Risk Associated with Type 2 Diabetes publication trend
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Technical terms
Type 2 diabetes: A chronic metabolic disorder characterised by insulin resistance, impaired insulin secretion and chronic elevation of blood glucose levels.
HbA1c: Glycated haemoglobin, reflecting mean plasma glucose concentration over the preceding two to three months, used to diagnose and monitor diabetes.
Relative risk: The ratio of the probability of an outcome occurring in an exposed group (for example, people with diabetes) to that in an unexposed group.
Absolute risk: The actual observed incidence or probability of an event in a defined population over a specified timeframe.
Coronary artery disease (CAD): A condition characterised by atherosclerotic narrowing of the coronary arteries, leading to reduced blood flow to the heart muscle.
References
- Sex-specific risks for cardiovascular disease across the glycaemic spectrum: a population-based cohort study using the UK Biobank. The Lancet Regional Health - Europe (2023).
- Sex differences in type 2 diabetes. Diabetologia (2023).
- Failure to control conventional cardiovascular risk factors in women with type 2 diabetes might explain worse mortality. Diabetes/Metabolism Research and Reviews (2023).
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