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Studies: Gender factor of major importance in diabetes


Management of diabetes: So far, the “gender” factor has not been considered
Over six million people in Germany suffer from diabetes, most of them with type 2. Various factors such as age or accompanying health problems are taken into account when managing the disease, but the gender is not. However, experts believe that treating diabetes should be gender-specific.

Millions of people suffer from diabetes
According to the German Diabetes Society, over six million people in Germany suffer from diabetes. In other countries, too, the metabolic disorder has long become a widespread disease. Diabetes is divided into type 1 and type 2. With type 1, the body produces almost zero insulin. The disease is triggered by a disturbance in the body's immune system. In type 2, being overweight or obese and lack of exercise contribute to the insulin not being fully effective in the cell membranes. Stress is also considered a risk factor for type 2 diabetes. Most patients with diabetes have type 2.

Personalized treatment of the metabolic disorder
According to the German Center for Diabetes Research (DZD), the primary therapy for type 2 diabetes is diet and exercise. At least at the beginning of diabetes, the supplementary therapy with oral antidiabetic drugs uses the body's own insulin production and the existing insulin. Insulin therapy may only be necessary in the further course. However, the experts write which therapy is the right one in each individual case. Experts from MedUni Vienna should also agree to this. In her opinion, the treatment of diabetes should be personalized.

Men and women are at different risk
According to a statement from the university, the international guidelines for the management of diabetes mellitus (type 2) stipulate factors such as age, the social environment, the duration of the illness or accompanying health problems. However, the gender is not included. However, according to the Austrian experts, this is becoming increasingly important - because men and women are at different risk and develop and suffer from diabetes differently. Therefore, the treatment should also be increasingly gender-specific and therefore personalized.

Women are "protected" from diabetes for a long time
This is the most important finding of a global review of the status of gender differences, to which the MedUni Vienna researchers Alexandra Kautzky-Willer and Jürgen Harreiter have now been invited. The review was published in the specialist journal "Endocrine Reviews". According to the communication, the facts clearly speak for gender-specific consideration and treatment of diabetes mellitus. Biologically, men have a fundamentally higher risk of developing diabetes mellitus, and women are "protected" for a long time, among other things, by the increased release of the hormone estrogen - until there is a hormonal change in menopause and this protection wanes. It is also said that the risk for men is mostly increased because they have more belly fat and more liver fat and are less sensitive to insulin, even if they are not overweight. For them, a testosterone deficiency is a risk factor, while for women higher male sex hormones are associated with a higher risk.

Thigh fat can have a protective effect
“On the other hand, it was shown that the fat on the thighs, which is more common in women due to genetics and estrogen, can even have a protective effect. On the other hand, the abdominal circumference has better diabetes predictive power than men, ”explained Kautzky-Willer, diabetes expert and Austria's first professor of gender medicine. “In addition, psychosocial stress and stress in the job, as well as a lack of decision-making competence in the case of high work pressure or lack of sleep, lead more often to diabetes in women than in men. Often also increased by weight gain. ”However, men are more at risk of developing diabetes later if their mothers have suffered from malnutrition during pregnancy.

Gender-specific factors should flow into practice
According to the scientists, there are also gender-specific differences in the biomarkers that can help to identify the risk of diabetes at an early stage. For example, the protein fetuin-A produced by the liver and copeptin are promising biomarkers in women, but not in men. According to this, the hormone leptin, which sends out chemical messages, stops eating and gains energy from stores, such as fat deposits, is considered a strong biomarker. "Endocrine disruptors, hormone-active substances, are also becoming increasingly important," said Jürgen Harreiter. Scientific studies have shown that synthetically manufactured substances such as bisphenol A or phatalates (plasticizers), which are contained in many plastic articles, are considered risk factors for diabetes. Here, too, there are different effects for men and women, depending on age. There were also regional differences: According to this, more and more women in Oceania, South and Central Asia and the Middle East develop diabetes, whereas the disease affects more and more men in richer areas of the Asia-Pacific region, but also in Central Europe. According to the university, the gender-specific factors in diabetes should flow into practice even more than before. (ad)

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