sábado, 23 de marzo de 2019

Diabetes in Men versus Women

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By Hannah Simmons, B.Sc.Reviewed by Chloe Barnett, BSc

Diabetes, especially type 2, is more common in males rather than females. However, females often have more serious complications and a greater risk of death.

Image Credit: Eviart / Shutterstock

Glucose is usually metabolised and regulated at low levels in the blood through the function of a pancreatic hormone called insulin. This hormone is released after a meal, stimulating the cellular uptake of sugar and allowing it to be used and/or stored.

However, in diabetes, cells are resistant to this hormone, leading to increased glucose levels in the blood. Over time, the lack of blood sugar control can result in life-threatening complications, if not correctly managed.

There are two types of diabetes, type 1 which is more common in children and type 2 which is more common in adults. Type 1 diabetes is caused by an autoimmune responseto insulin producing beta cells in the pancreas and is associated with genes and environmental factors.

Type 2 diabetes is due to increased insulin resistance, associated with weight gain, inactive lifestyles and poor diet. Type 2 diabetes is more frequently found in men, especially at ages of 35-54, where men are twice as likely to develop diabetes, with onset at a much lower average BMI.

Testosterone and Diabetes

The androgen hormone ‘testosterone’ is vital in male puberty. It stimulates the growth of muscles and hair, vocal changes and genital development. This hormone is also important throughout the life of a man, aiding the production of sperm and maintenance of libido.

Females also produce testosterone at extremely low volumes, which helps to maintain the balanceof hormones, particularly after menopause.

Research has recently shown that there is link between this hormone and development of type 2 diabetes in men, with lower testosterone levels leading to a greater risk. Conversely, it has been identified that women with high blood testosterone levels are at greater risk.

Testosterone is involved in the deposition of fats. There are two different types of fat deposition, subcutaneous fat deposition and visceral fat deposition, which differ by their location, with the former at the surface of the skin and the latter located around organs.

Type 2 diabetes has a direct correlation with increased risk of visceral fat deposition. Research has also shown that low testosterone levels in men can increase e visceral fat deposition, leading to increased type 2 diabetes.

This is particularly worrying as 1/6th of all males have low testosterone, which leads to poor muscle formation, increased fat storage, and leads to a dramatic increase in diabetes risk.

Complications of diabetes in men and women

Most diabetic symptoms are the same in men and women. These general symptoms include constant thirst, constant urination, fatigue, dizziness and weight loss.

However, symptoms which are particularly observed in men are loss of muscle mass and genital thrush. Additionally, women often experience symptoms such as genital yeast infections, urinary tract infections and polycystic ovary syndrome.

If not correctly managed, diabetes can lead to many serious health complications. These include amputation, neuropathy, retinopathy, cardiovascular disease and kidney disease. 45% of males with diabetes also develop erectile dysfunction due to nerve, muscle and blood vessel damage. However, women have a much greater chance of heart disease, kidney disease and depression. Overall, this makes it far more life-threatening for women in comparison to men.

An additional issue which women with diabetes is menopause. The combination of diabetes with this change in hormones can lead to further increase in blood glucose, weight gain and problems with sleeping. This can therefore lead to further development of serious complications, further exacerbating previous health issues.

Overall, males can develop diabetes at a lower BMI, with additional complications such as erectile dysfunction and muscle mass loss. One possible reason for this is the loss of testosterone in later life in men.

However, women with diabetes face consequences which are more serious, such as possible heart disease. Therefore, diabetes affects each sex differently and can lead to serious life-altering health complications.