Abstract
To examine sex differences in trajectories of glucose and insulin prior to the development of type 2 diabetes. Glucose and insulin levels from oral glucose tolerance tests performed every 5 years in the prospective Whitehall II cohort were analysed using mixed-effects models. Out of 6,712 White participants, 475 men and 177 women developed diabetes during a median follow-up time of 14 years. Men who developed diabetes had higher fasting glucose levels than women over the entire follow-up period (P < 0.001), whereas trajectories of 2-h glucose did not differ between sexes (P = 0.34). Two-hour insulin levels tended to be higher among women than men developing diabetes (P = 0.05), but not after adjustment for height (P = 0.45). Men have higher fasting glucose levels than women many years before the diagnosis of diabetes and at time of diagnosis, indicating that the pathogenesis of diabetes may be different between sexes.
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Acknowledgments
We thank all participating civil service departments and their welfare, personnel and establishment officers; the Occupational Health and Safety Agency; the Council of Civil Service Unions; all participating civil servants in the Whitehall II study; and all members of the Whitehall II study team. The Whitehall II study is supported by the following bodies: Medical Research Council, Economic and Social Research Council, British Heart Foundation, Health and Safety Executive, and Department of Health (UK), National Heart Lung and Blood Institute (HL36310), National Institute on Aging (AG13196), Agency for Health Care Policy Research (HS06516), and The John D and Catherine T MacArthur Foundation (USA).
Conflict of interest
Steno Diabetes Center A/S receives part of its core funding from unrestricted grants from the Novo Foundation and Novo Nordisk A/S. K. F., D. V. and D. W. are employed by Steno Diabetes Center A/S, a research hospital working in the Danish National Health Service and owned by Novo Nordisk A/S. K. F., D. V. and D. W. own shares in Novo Nordisk A/S. The remaining co-authors have nothing to declare.
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Communicated by Guido Pozza.
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Vistisen, D., Witte, D.R., Tabák, A.G. et al. Sex differences in glucose and insulin trajectories prior to diabetes diagnosis: the Whitehall II study. Acta Diabetol 51, 315–319 (2014). https://doi.org/10.1007/s00592-012-0429-7
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DOI: https://doi.org/10.1007/s00592-012-0429-7