Across ethnic groups, men are significantly more likely to develop diabetes than women, with the risk persisting after factoring in age and BMI, according to an analysis of UK Biobank data.
“Men tend to cope with being overweight or obese better than women, and tend to underestimate their weight more than women do,” Naveed Sattar, MD, professor of metabolic medicine at the BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Scotland, told Endocrine Today. “Yet, at any given BMI, men have higher risks for mortality. Previously, we and others have shown that men also have higher rates of diabetes in middle age than do women. In this paper, we wanted to ask whether men from other major ethnicities likewise experience more diabetes compared with women, matched for age and BMI and other factors, such as activity levels.”
In a cross-sectional study, researchers analyzed data from 489,079 participants aged 40 to 69 years (266,266 women) participating in UK Biobank, a population-based cohort study initiated in 2007 to examine lifestyle, environmental and genetic determinants of a range of diseases. Researchers compared the prevalence of self-reported diabetes across white (96.4%), South Asian (1.6%), black (1.6%) and Chinese (0.3%) adults. Results were standardized for age, socioeconomic status, BMI and lifestyle factors, including physical activity, TV viewing, smoking status and intake of various foods.
The overall crude diabetes prevalence among men and women was 6.9% and 3.7%, respectively. The difference persisted after standardizing for age, socioeconomic status, BMI and lifestyle factors, falling slightly in men to 6.4% and rising slightly among women to 3.9% (P < .0001). Excluding patients with type 1 diabetes did not change the findings.
Across all ethnic groups, the standardized prevalence of diabetes was higher for men vs. women. Rates were 6% vs. 3.6% for white men and women, 21% vs. 13.8% for South Asian men and women, 13.3% vs. 9.7% for black men and women, and 7.1% vs. 5.5% for Chinese men and women, respectively, although the sex difference among Chinese participants did not rise to statistical significance. The sex differences persisted after excluding people with type 1 diabetes.
In subgroup analysis of South Asian participants, the researchers also observed the highest prevalence among Bangladeshi men, followed by Pakistani and Indian men vs. women.
The researchers noted that the nonsignificant sex difference in diabetes prevalence among Chinese adults may be attributable to the small number of participants in the cohort (965 women and 569 men), adding that a large study of 46,239 Chinese adults showed the age-standardized prevalence of total diabetes were 10.6% and 8.8% among men and women, respectively.
“We suggest more work is needed to increase physician and public awareness of men’s greater diabetes risk, to better educate, target and motivate men at elevated risk to [make] lifestyle changes,” Sattar said. – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.