Men Are at Greater Risk Than Women of Diabetes Complications Like Stroke

This content originally appeared in everyday health. It was reissued with permission.

by Becky Upham

Key takeout

• Recent studies have shown that among people with diabetes, men are at a higher risk than women for complications such as heart attacks and strokes, eye and kidney problems, and in extreme cases, amputation.
• Complications increased with longer living with diabetes.
• Men may have more complications as they are less likely to take medication or go to a doctor.

A longitudinal study published May 16 in the Journal of Epidemiology & Community Health shows that men are at increased risk for major health complications, both type 1 and type 2 diabetes.⁽¹⁾

Diabetic men have a 50% higher risk of heart disease and stroke, leg and foot complications (called neuropathy, amputation, amputation, kidney complications, and diabetic retinopathy), said Emma Cox, a doctoral candidate at the Charles Perkins Center at the University of Sydney.

“While complication rates increased with the duration of diabetes, the male and female disparities were consistent, highlighting the need for complication screening and prevention strategies from the time of diabetes diagnosis,” Cox says.

Approximately 38 million people in the United States suffer from diabetes, which is estimated to be 11.6% of the population. The percentage of undiagnosed men and women with undiagnosed diabetes is closer to 20 million men compared to 18 million women.⁽²⁾

To track diabetes complications, the study followed 25,000 people for 10 years

To investigate the prevalence of diabetes complications and how it relates to gender, the researchers used survey responses from the Australian study 45 and older, a large prospective study of over 250,000 people aged 45 and older in New South Wales. By linking respondents to medical records, the researchers determined that approximately 10% of participants had type 1 or type 2 diabetes.

Over the course of a decade, researchers monitored research subjects for diabetes to see if they developed any of the major health issues associated with conditions including eye problems, such as heart disease, eye problems such as cataracts and diabetic retinopathy, nerve damage, mild or major amputation.

Men with diabetes were more than 50% more likely to develop cardiovascular disease than women.

After adjusting for age, the researchers found that men were 51% more likely to develop cardiovascular disease than women, 47% more likely to have leg and foot complications, 55% likely to have kidney complications, and 14% more likely to have diabetic retinopathy.

In both men and women, the risk of complications increased with the years they lived with diabetes, but the risk for men continued to be higher.

“While the rate of complications is slightly lower among women, it remains important to note that the rate of complications is very high for both genders,” says Dr. Alice Gibson, a researcher at the Charles Perkins Center.

Additionally, these figures only reflect those with no complications at the start of the study and do not account for those with existing or multiple complications. That is, the overall burden of complications in diabetics is likely to be much higher than what the study found, adds Dr. Gibson.

People with diabetes need individual and comprehensive care

“The biggest point is that diabetes significantly increases the risk of complications and requires individualized and comprehensive care to reduce the risk of microvascular complications.”

The study states that gender differences in the risk of diabetes complications are extremely important, but it is important to note that some of the key risk factors are not included in the study, says Dr. Tan.

“Extremely, this study did not consider the use of drugs, including glycemic control, lipid control, blood pressure control, and drugs that may increase or decrease cardiovascular risk,” she says.

The authors acknowledged that these missing factors were limitations to the study and omitted by those with a history of complications.

Tan said the findings are also limited due to the type of data used. Many complications of diabetes appear in ways that don’t necessarily manifest themselves in hospital claims, and the study misses them, she says.

Men may be less likely to take medication or undergo regular health checks

The authors provide several theories as to why men and women have different risks. First of all, in this study, the men in this study were about 50% more likely to have existing heart disease, Gibson says.

Men in the US are likely to have similar increased risks, Gibson says.

She says men from both countries are unlikely to make lifestyle changes, take preventive medications, or undergo health checks to reduce their risk.

“Studies from both countries show that men are more likely to have high blood pressure and cholesterol, poor control of diabetes, overweight, and smoke smoke, a well-known risk factor for complications of diabetes,” says Gibson.

Women, such as breastfeeding and using hormone replacement therapy, also have protective factors that may have contributed to gender differences, Gibson says.