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Diabetes and sex: from pathophysiology to personalized medicine

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Abstract

The prevalence and incidence of diabetes is similar in the two sexes but the long-term impact of diabetes on vascular and non-vascular complications is more gender specific. Men, in comparison with women, seem to be at higher risk for micro-vascular complications, such as severe retinopathy and nephropathy. On the other hand, the impact of diabetes on the risk of major cardiovascular events is different in women in comparison with men. Both type 1 and type 2 diabetes are associated with a significant increase in the incidence of bone fractures. Although this phenomenon is present in both sexes, its impact is greater in women, due to the higher baseline incidence of fractures. Diabetes negatively affects mood, leading to an increased risk of depressive disorders, due to the burden and side effects of therapy, together with the fear of complications. This phenomenon can be more evident in women, who are at greater risk of depressive disorders. Non-pharmacological treatments (i.e. diet and exercise), which are the backbone of therapy for type 2 diabetes, do not differ across genders. On the other hand, some drugs could have diverse profiles of action in women and in men. In relation to diabetes, the sex-related difference in platelet activity and platelet inhibitory response to anti-aggregating therapy, reported in the general population, was observed also in diabetic women.

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Abbreviations

RIKS-HIA:

Register of Information and Knowledge about Swedish Heart Intensive Care Admission

DPP4:

Dipeptidyl peptidase 4

HAPI:

Heredity and phenotype intervention

MI:

Myocardial infarction

ETDRS:

Early treatment diabetic retinopathy study

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Authors and Affiliations

  1. Department of Medical and Surgical Critical Care, University of Florence, SOD Atherothrombotic Diseases, AOU Careggi, Viale Morgagni, 85, 50134, Florence, Italy

    Rosanna Abbate, Gabriele Cioni, Cinzia Fatini & Rossella Marcucci

  2. Diabetes Section, Geriatric Unit, Department of Medical and Surgical Critical Care, University of Florence, Azienda Ospedaliero Universitaria Careggi, Viale Morgagni, 85, 50134, Florence, Italy

    Edoardo Mannucci

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  1. Rosanna Abbate
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  2. Edoardo Mannucci
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Correspondence to Gabriele Cioni.

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Abbate, R., Mannucci, E., Cioni, G. et al. Diabetes and sex: from pathophysiology to personalized medicine. Intern Emerg Med 7 (Suppl 3), 215–219 (2012). https://doi.org/10.1007/s11739-012-0804-y

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