Men and women have different fat distribution, affecting their risk of cardiovascular disease and type 2 diabetes. Men generally develop type 2 diabetes earlier and at a lower BMI than women, with abdominal fat in obese men with type 2 diabetes showing higher insulin resistance and different gene expression levels than women. A study from Australia found men are more likely to develop type 1 and type 2 diabetes-related complications. Men with type 2 diabetes and obesity exhibit higher levels of insulin resistance in their adipose tissue than women, due to less efficient inhibition of fat cell lipolysis, raising free fatty acid levels contributing to inflammation and insulin resistance.
Researchers recruited 2,344 women and 787 men for a study on metabolism. They found men with obesity had higher circulating fatty acid and insulin levels than women with obesity. Discovery of differences in lipolysis, fat production, and sensitivity in cells with obesity in men and women were noted. Women with obesity had 10 times higher insulin sensitivity than men, while fat cells from men with obesity exhibited twice the rate of lipolysis compared to women. Gene expression differences, including less expression of the gene IRS1 in men than in women, were found, suggesting sex differences in metabolic pathways in adipose tissue due to hormone profiles.
Men are at greater risk of developing complications related to type 1 and type 2 diabetes than women, according to a study from Australia, showing men had a higher risk of cardiovascular disease, lower limb complications, kidney complications, and diabetic retinopathy. Sex differences in insulin resistance raise questions about possibly tailoring treatment pathways for men and women with diabetes. Pharmaceutical and lifestyle interventions targeting insulin resistance in men with obesity could help prevent type 2 diabetes.
Men and women exhibit different responses to treatment options for type 2 diabetes, with some GLP-1 agonists being more effective in women. Women have better insulin response, lipid profiles, and blood pressure until menopause. Insulin resistance in men with obesity could be specifically targeted to prevent type 2 diabetes, but more research is needed. Studies need to explore sex and gender differences in therapies and interventions for diabetes. Future research should focus on changes in body composition, such as fat distribution and lean mass, to detect new treatment targets for men and women with diabetes.
The study had limitations, as the majority of participants were of white European origin, limiting extrapolation of findings to other populations. People of African and Asian ancestry are more likely to develop type 2 diabetes, highlighting the need for diversifying participant cohorts in diabetes studies. Further research focusing on sex and gender differences in diabetes treatment and pathophysiology is essential for developing tailored interventions for men and women with diabetes.
