Study finds different health patterns after type 2 diabetes diagnosis for women and men

Researchers examined anonymised, linked primary- and secondary-care electronic health records from the UK Clinical Practice Research Datalink. They studied 28,720 people whose type 2 diabetes was newly identified between 2010 and 2020.

Men made up 62% of the group. Their median age when type 2 diabetes began was 54. Women were generally older at diagnosis, with a reported mean age of 56. The researchers followed people for a median of 6.8 years.

The team used a method designed to map changes between health states over time. They looked at diagnoses of high blood pressure, cardiovascular disease, end-stage renal disease and mental health conditions after type 2 diabetes began. Cardiovascular disease refers to conditions affecting the heart and blood vessels. End-stage renal disease is severe kidney failure.

During follow-up, 39% of the group moved to another health state tracked in the study. High blood pressure was the most frequent event after a type 2 diabetes diagnosis across age groups and sexes.

The patterns differed between women and men. Women were more likely to receive a mental health diagnosis after type 2 diabetes began: 8.1% did so, compared with 5.3% of men. The study also found that women had higher average healthcare use and more long-term prescriptions than men.

Men were more likely to enter a trajectory involving cardiovascular disease or end-stage kidney disease. This applied to 8.4% of men, compared with 5.3% of women. Men were also more likely to have a hypertension trajectory, at 21.1% compared with 20.2% of women. Most events happened earlier for men than for women, according to the researchers.

For both women and men, a combination of type 2 diabetes and a mental health condition was associated with earlier death compared with the other health patterns studied. The abstract does not provide a number for that difference, and this result does not show that one condition caused the other.

Because this was an observational study, it can identify patterns in recorded care but cannot prove their cause. In particular, the authors say the difference in mental health diagnoses may partly reflect differences in healthcare-seeking behaviour, rather than a true difference in how common these conditions were. Women’s higher use of services and long-term prescriptions may also affect how often conditions are identified in records.

The findings come from people receiving care in the UK, so the same patterns may not apply everywhere. The abstract also does not describe details such as participants’ ethnicity, financial circumstances, diabetes severity or other health differences that could help explain the results.

The study did not test a screening programme, a treatment or a new care plan. Its value is in showing that physical and mental health patterns after type 2 diabetes diagnosis may not be the same for everyone. Further research would need to test whether care approaches tailored by sex, age or other factors improve health outcomes.