Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Type 1 diabetes (T1D) is an autoimmune condition that impacts men and women in unique ways. Our bodies respond differently to the impact of T1D on our immune systems. However, the disease does have some shared challenges. Everyone with this condition will need to manage their blood sugar levels and try to avoid further complications. Research does show a few differences in how men and women experience, manage, and are affected by the disease. Understanding these gender-specific effects can help people get more personalized and effective care. Here is what you need to know!
Gender-Specific Effects of T1D
For Women
Higher Risk of Mortality and Complications
Studies show that women with type 1 diabetes have a 40% greater risk of dying from all causes than men with the same condition. They are also twice as likely to have severe vascular events, such as heart attacks or strokes. These risks often come from differences in how cardiovascular disease is treated and managed in women. Generally, women are less likely to receive preventive treatments like cholesterol-lowering medications or antithrombotic therapies. Cardiovascular risk factors, such as high blood pressure and cholesterol, are also diagnosed less often in women than in men. This is also true for women with type 2 diabetes (T2D). The risk of heart disease increases nearly six-fold for women with T2D compared to women without the condition. They are also at a higher risk of developing kidney disease.
Glycemic Control and Insulin Use
Women with type 1 diabetes often have poorer glycemic control compared to men. Interestingly, women are more likely to use insulin pumps and follow intensive insulin therapy, but these do not always lead to better outcomes. In fact, women tend to have higher rates of hypoglycemia (low blood sugar), which can be dangerous if not managed effectively.
Weight and Body Image Challenges
Women with type 1 diabetes are more likely to struggle with obesity than men. This can complicate blood sugar management and increase the risk of cardiovascular issues. Additionally, societal pressures around body image may lead some women to engage in unhealthy behaviors, such as skipping insulin doses to lose weight—a condition sometimes referred to as "diabulimia."
Hormonal Influences
Hormones play a big role in how women experience type 1 diabetes. Menstrual cycles, pregnancy, and menopause can all affect blood sugar levels and insulin sensitivity. Women often need to adjust their diabetes management strategies during these stages to keep their blood sugar levels stable.
For Men
Fertility
Type 1 diabetes can affect male fertility. If blood sugar levels are not controlled, it can damage nerves and blood vessels. If this happens in male sexual organs, it can lead to erectile dysfunction. There is also research into how diabetes can affect sperm production. What they found is that the condition can cause genetic changes, specifically something called DNA fragmentation, that can lead to higher rates of infertility.
Muscle Mass
When blood sugar levels are consistently higher than they should be, your body may end up breaking down muscle and fat for energy. This can happen to anyone, but is more common in men.
Care Gaps in Treating Diabetes
There have been significant strides made in treating diabetes over the past few decades. However, despite these advancements, there are still gaps in how care is delivered to men and women. Conditions like heart disease are often overlooked or underdiagnosed in women. This leads to delayed treatment and worse outcomes. This phenomenon is sometimes referred to as "Yentl syndrome." Men and women do metabolize insulin differently. For instance, testosterone can increase insulin resistance in men. Women on the other hand tend to be more sensitive to insulin, especially during certain hormonal changes.
Bridging the Gender Gap
To address these disparities, there are a few gender-specific strategies for managing type 1 diabetes to pay attention to! The first is to have personalized treatment plans. Insulin dosages and medications should account for hormonal changes, weight differences, and cardiovascular risks unique to each gender. Regular screenings for cardiovascular disease can help catch issues before they become more serious. Finally, education and support need to be constantly provided. Giving patients information tailored to their unique challenges, such as managing diabetes during pregnancy or addressing ED, can empower them to take control of their health.
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Type 1 diabetes does not affect men and women equally. By understanding these differences, patients and providers can work together to close the gender gap in diabetes care and improve outcomes for everyone living with this condition!
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