04 Sep Surprising Gender Differences in Diabetes Prevalence Over 25 Year Period
Medical Research: What are the main findings of the study?
Dr. Menke: The prevalence of diabetes increased more in men than women between 1976 and 2010 in the US, from 4.7% to 11.2% in men and from 5.7% to 8.7% in women. Changes over time in the distribution of age, race/ethnicity, and obesity in the population explained all of the increase in women and only half of the increase in men.
Medical Research: Were any of the findings unexpected?
Dr. Menke: Yes, the differences by men and women were surprising. The factors we studied explained all of the rising prevalence of diabetes in women, but not in men. We know that survival over time has improved more for diabetic men than women, which may explain some of our results, but we could not explore this directly as a reason for the difference that we found. Other factors that may explain the difference, but that we could not explore in our research, are differences between men and women over time in such factors as physical activity (both recreational and occupational), sleep patterns, vitamin D levels, psychological stress and depression, and environmental and occupational exposure to pollutants and toxins. These are potentially other useful avenues to explore in future research.
Medical Research: What should clinicians and patients take away from your report?
Dr. Menke: Overweight and obesity were the greatest contributors that we saw to the increase in prevalence over time, in both men and women. Unlike aging, race, and ethnicity, body mass can be changed. Studies like the NIH-funded Diabetes Prevention Program have shown that lifestyle changes including a modest weight loss and increased activity have a significant impact in preventing type 2 diabetes among those at greatest risk.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Menke: The substantial contribution of body mass index to the increase in the prevalence of diabetes highlights the importance of developing effective interventions aimed at reducing the number of people who are overweight and obese. Also, nearly half of the increase in diabetes prevalence in men remains unexplained and further research is necessary to investigate what additional factors contribute to the faster rise in diabetes in men than women.
Menke A, Rust KF, Fradkin J, Cheng YJ, Cowie CC. Associations Between Trends in Race/Ethnicity, Aging, and Body Mass Index With Diabetes Prevalence in the United States: A Series of Cross-sectional Studies. Ann Intern Med. 2014;161:328-335. doi:10.7326/M14-0286