Receiving a diagnosis of type 2 diabetes may involve more than requiring close management of blood sugar levels. People with the disease often face an increased risk of comorbidities, such as heart disease, kidney disease, or anxiety.
However, these conditions may not develop in the same way for everyone. In a new study, researchers examined whether men and women experienced different health patterns following a type 2 diabetes diagnosis and how those patterns varied by age.
The study authors believe the findings could help healthcare providers provide more individualized care.
The study is published in PLOS Medicine.
The Centers for Disease Control and Prevention (CDC) estimate that around 40.1 million people in the United States have diabetes, and type 2 diabetes accounts for the vast majority of adult cases.
People can manage type 2 diabetes by making lifestyle changes and taking medications, such as metformin. If it is left unmanaged, diabetes can contribute to serious health issues, such as heart or kidney disease.
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For the new study, the researchers used health information from the United Kingdom Clinical Practice Research Datalink (CPRD).
Their analysis included 28,720 people who received a diagnosis of type 2 diabetes between 2010 and 2020. Men made up 62% of the cohort and had a median age of 54 at diabetes onset, while women had a median age of 56.
The researchers excluded anyone who had already received a diagnosis for one of the study’s specified outcomes before developing type 2 diabetes:
The team followed participants for a median of 6.8 years. They grouped participants according to whether they developed diabetes at ages 16 to 39, 40 to 59, or 60 and older.
The researchers also tracked the order and timing of comorbid conditions the participants developed after their type 2 diabetes diagnosis.
For the analysis, the team grouped anxiety, depression, and somatoform disorders into one mental health category. They combined cardiovascular conditions and end-stage renal disease into another category and kept hypertension as a separate category.
During follow-up, 39% of participants had at least one of the events included in the analysis.
The most common comorbid condition the participants developed was hypertension, regardless of age and sex group. It affected 20.2% of women and 21.1% of men.
The other categories painted a different picture, however.
About 8.1% of women developed a mental health condition after diabetes, compared with 5.3% of men. Women ages 16 to 39 had the highest probability of developing anxiety, depression, or a somatoform disorder.
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Men were more likely to develop cardiovascular or end-stage renal disease, with 8.4% receiving either diagnosis compared with 5.3% of women.
Study author Fabiola Eto, PhD, a postdoctoral research associate at Queen Mary University of London, spoke with Medical News Today about the study findings, and explained that the records showed when clinicians first documented a condition, not necessarily when it began.
Eto pointed out that women averaged 92 primary care consultations compared with 32 among men, so the findings could be possibly explained by women having more opportunities for these conditions to be identified.
“Some conditions may simply be recorded sooner in women rather than occurring at genuinely different rates,” she explained.
The researchers also linked mental health trajectories with the earliest mortality.
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Eto emphasized that the study did not establish why these participants died earlier. However, she said the association makes the combination of diabetes and mental health conditions “a red flag worth investigating further, rather than a proven mechanism.”
Cheng-Han Chen, MD, a board-certified interventional cardiologist at MemorialCare Saddleback Medical Center in California, told MNT that the findings could eventually support more individualized diabetes care if future studies confirm them.
Chen, who was not involved in the study, told us:
“We don’t yet know what is driving these differences. Some of the findings may reflect differences in how commonly certain conditions are diagnosed in men and women, rather than a direct effect of diabetes.”
He cautioned against changing guidelines based on one observational study. However, he emphasized that comprehensive preventive care remains “essential.”
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“People with diabetes should routinely have their blood pressure, kidney function, cardiovascular risk, and mental health assessed as appropriate,” he recommended.
Jay Luthar, MD, founder and medical director of Lutanen Health and an instructor at Harvard Medical School, told MNT the findings reflect patterns that healthcare providers already observe.
“Type 2 diabetes doesn’t follow the same trajectory in women as in men,” Luthar, who likewise was not involved in the study, said.
He pointed to hormonal differences, men’s lower engagement with preventive care, and women’s greater healthcare use as possible explanations. He also advocated incorporating mental health screening into diabetes care without limiting it by sex.
“The most practical near-term change is routine psychological screening as a standard part of diabetes follow-up visits, for all patients, not just women,” Luthar advised.
