Women and men who develop type 2 diabetes tend to face different health threats in the years that follow, according to a study published Tuesday in PLOS Medicine: women more often go on to be diagnosed with a mental health condition, while men more often develop cardiovascular or kidney disease.
Researchers led by Fabiola Eto at Queen Mary University of London's Wolfson Institute of Population Health tracked 28,720 people in the United Kingdom who were newly diagnosed with type 2 diabetes between 2010 and 2020, drawing on primary-care records in the UK's Clinical Practice Research Datalink and following patients for a median of nearly seven years. Using a statistical method that models how patients move between different health states over time, the team compared what happened to men and women after their diabetes diagnosis.
Diverging paths after diagnosis
Women in the study developed a mental health condition — depression, anxiety or a related disorder — after their diabetes diagnosis more often than men did, 8.1% versus 5.3%. Men, meanwhile, more often went on to develop cardiovascular disease or end-stage kidney disease, 8.4% versus 5.3% of women. The gap in mental health diagnoses was most pronounced in women between the ages of 16 and 39, who had the highest probability of any group of developing a mental health condition after their diabetes diagnosis.
Women were more likely than men to be diagnosed with a mental health condition after the onset of T2D, with women aged 16–39 years old having the highest probability.
Fabiola Eto et al., PLOS Medicine
The study also found a stark mortality gap along a different path: among patients who developed anxiety, depression or a related disorder and then died, men in that trajectory died roughly nine years earlier on average than women, at about 61 versus 70. The authors say the pattern suggests diabetes care built around a single standard pathway may miss risks that fall unevenly by sex and age.
The authors are explicit that their findings are observational and describe associations rather than proven causes. The database captures only people who sought medical care, which likely leaves out healthier people who never saw a doctor, and hypertension was often diagnosed at nearly the same time as diabetes, which may have caused the study to undercount how often it led to later complications. The sample was also too small to break results down by ethnicity, and the design did not incorporate biomarkers or medication data that might help explain why the sexes diverge.
Even with those caveats, the authors argue the size of the gap is large enough to matter for everyday practice, and they suggest routine psychological screening could be built into standard diabetes care, particularly for younger women, while men may need closer monitoring of heart and kidney function as they age with the disease. The findings echo a broader pattern documented in other recent reporting on sex differences in diabetes outcomes, though the authors caution their UK-based cohort may not generalize to other health systems or populations.
