New research using data from the Sax Institute’s 45 and Up Study – one of the world’s largest longitudinal studies of healthy ageing – has revealed significant differences in the rates of complications between men and women who have been diagnosed with diabetes.
The researchers from the University of Sydney looked at over 25,000 participants from the 45 and Up Study who had been previously diagnosed with diabetes. Linking their survey responses with a range of medical and hospital records, the paper published in the Journal of Epidemiology and Community Health found rates of heart disease and complications of the leg, foot and kidney were all markedly higher in men, over an average monitoring period of around ten years.
Men were 51% more likely to develop heart disease than women, 47% more likely to have leg and foot complications and 55% more likely to have kidney complications. Men were also at slightly higher risk of diabetic retinopathy. While the rate of complications in both sexes rose with the number of years since diagnosis, the difference in the rates between men and women persisted.
The authors say that while rates of complications were found to be higher in men, it’s important to note that they remain very high in both sexes.
“These figures also do not account for people who had pre-existing complications or multiple complications – so the overall burden of complications in people with diabetes is actually much higher than what we report here,” says lead author Dr Alice Gibson, a researcher at the University of Sydney’s Charles Perkins Centre and Menzies Centre for Health Policy and Economics,
Although it’s not easy to pin down the cause of the different rates in men and women, co-author and PhD Candidate Emma Cox, of the same institutions, says there are some possible explanations.
“The men in our study were more likely to have risk factors for poorer health,” she says. “They were more likely to have preexisting heart disease, for example. And there is a lot of research evidence that men are more likely to have high cholesterol and blood pressure, less likely to control their diabetes, and more likely to be overweight and smoke – all risk factors in developing the complications we see with diabetes.”
On the other side of the equation, there could be potential protective factors in women, such as breastfeeding and hormone replacement therapy, Emma Cox adds.
The authors say their findings highlight the need for prevention and targeted screening for complications. More research is needed on the underlying mechanisms for the differences between men and women to inform interventions, they add.
The 45 and Up Study is Australia’s largest longitudinal study of health and ageing. For almost 20 years, it has been following over a quarter of a million people to understand how Australians are ageing and the factors that promote good health and wellbeing.
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Find out more about the 45 and Up Study here
