Gender Difference in Diabetes

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 43225

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ASSL Olbia, Via Bazzoni-Sircana 2, 07026 Olbia, Italy
Interests: hypertension; diabetes complications; cardiovascular system; metabolic syndrome; clinical nutrition; diabetes; cardiology
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Dear Colleagues,

During the two days of the meeting "Gender Differences in Diabetic Disease" to be held in Olbia, Italy on 4 and 5 December 2020, we will discuss the various medical, social, ethnic, and psychological aspects of gender differences, trying to get as broad a picture as possible of how these differences are present and evident in diabetic disease. We will also try to identify the still-unclear points that deserve further studies. As Guest Editor of this Special Issue of Diabetology, "The Gender Differences in Diabetic Disease" I am inviting you to submit an article/review on the topic that you will present at the meeting. The instructions on how to proceed with writing will be available on a dedicated web page which I will shortly send you. The official deadline for submitting the paper will be 31 March 2021, but it can be done after the end of the meeting. I would like to take this opportunity to thank you again for agreeing to attend the meeting we will have in December, and I hope you will accept this invitation to prepare a small review.
I look forward to seeing you in Olbia!

Prof. Dr. Giancarlo Tonolo
Guest Editor

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Keywords

  • Nutrition
  • Technology
  • Sexuality
  • Psychology
  • Psychiatry
  • Ethnic
  • Anthropology
  • Drug therapy
  • Microvascular complications
  • Macrovascular complications
  • Cardiovascular

Published Papers (11 papers)

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Editorial

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2 pages, 162 KiB  
Editorial
Editorial to “Gender Differences in Diabetes”
by Giancarlo Tonolo
Diabetology 2023, 4(1), 62-63; https://doi.org/10.3390/diabetology4010007 - 3 Feb 2023
Viewed by 1182
Abstract
Welcome to this Special Issue of Diabetology entitled “Gender Difference in Diabetes” [...] Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)

Research

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10 pages, 501 KiB  
Article
Neurocognitive Disorders in Post and Long Covid Patients: Preliminary Data, Gender Differences and New Diabetes Diagnosis
by Concetta Mezzatesta, Sara Bazzano, Rosa Gesualdo, Simone Marchese, Maria Luisa Savona, Mario Tambone Reyes and Vincenzo Provenzano
Diabetology 2022, 3(4), 514-523; https://doi.org/10.3390/diabetology3040039 - 6 Oct 2022
Cited by 1 | Viewed by 1834
Abstract
The research is based on a clinical observation of the neurological and neuro-cognitive status of 300 patients, belonging to the Partinico Hospital and the Post-Long Covid clinic, which had contracted the SARS-CoV-2 virus in the period between April 2021 and May 2022. In [...] Read more.
The research is based on a clinical observation of the neurological and neuro-cognitive status of 300 patients, belonging to the Partinico Hospital and the Post-Long Covid clinic, which had contracted the SARS-CoV-2 virus in the period between April 2021 and May 2022. In this paper, we present the analysis of the first 100 patients subjected to a neurocognitive screening protocol. The procedure consists of tests that examine the mechanism of different brain domains to check for the presence of cognitive deficits that arose after the negativization of the viral infection. Through a neurocognitive protocol, the research aims to investigate different brain areas and mental functioning. This allowed us to raise the possibility that the presence of cognitive alterations may be related to the evidence of point-like brain alterations (from the cortex to the trunk) visible through neuroimaging techniques. In the article, we highlight the hypothesis that SARS-covid 2, as stated in recently published studies, can produce an alteration of executive functions such as to configure a real dysexecutive syndrome. This research evaluates the symptomatic gender variability within the sample, the presence of important differences in the affective state, and provides a first observation of the impact of SARS-CoV-2 in diabetic pathology as well. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
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9 pages, 209 KiB  
Article
Gender Inequality and Well-Being of Healthcare Workers in Diabetology: A Pilot Study
by Tatiana Lai, Sofia Cincotti and Cristian Pisu
Diabetology 2022, 3(3), 384-392; https://doi.org/10.3390/diabetology3030029 - 21 Jun 2022
Cited by 1 | Viewed by 2090
Abstract
Several factors affect the relationship between a diabetic patient and a healthcare worker. Among these, there is the well-being of healthcare workers and how they perceive their work environment, especially in the context of the presence or absence of gender inequality. To show [...] Read more.
Several factors affect the relationship between a diabetic patient and a healthcare worker. Among these, there is the well-being of healthcare workers and how they perceive their work environment, especially in the context of the presence or absence of gender inequality. To show the importance of these aspects, a selected sample of healthcare workers who were exposed daily to people (mainly diabetic patients) within the working environment were interviewed. The different opinions of the interviewees show that in an environment where factors that negatively affected their work and personal well-being were minimized, healthcare workers were able to fully express their potential. They expressed great satisfaction with their work involving daily contact with patients, while achieving the type of patient–healthcare worker relationship model desired for a better management of diabetic patients’ care. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
11 pages, 246 KiB  
Article
Sex/Gender Psychological Differences in the Adult Diabetic Patient and How a Child’s Response to Chronic Disease Varies with Age and Can Be Influenced by Technology
by Maria Antonietta Taras and Alessandra Pellegrini
Diabetology 2021, 2(4), 215-225; https://doi.org/10.3390/diabetology2040019 - 1 Nov 2021
Cited by 1 | Viewed by 2910
Abstract
Chronic diseases have a negative impact on quality of life and perceived well-being. Depression tends to be more frequent in people with chronic diseases than the general population, and, for example, in diabetes, it has an incidence of two to three times higher [...] Read more.
Chronic diseases have a negative impact on quality of life and perceived well-being. Depression tends to be more frequent in people with chronic diseases than the general population, and, for example, in diabetes, it has an incidence of two to three times higher and often remains under-diagnosed. The inability to control and predict the course of the disease exposes chronic patients to mood fluctuations which are often difficult to manage, also in virtue of the fact that in any chronic pathology a stabilization aimed at attenuating the symptoms or slowing the course is pursued, but it cannot tend to achieve complete healing. This fact of incurability for many subjects means the loss of control over their own body, in which the social and family role is also perceived as compromised and the experienced distress can result in the appearance of underlying disorders, both psychological or psychiatric. In this area, there is currently a great deal of focus on sex/gender differences. The aim of this article is to highlight these differences with regard to the emotional aspects that most affect the management of diabetic pathology. In this paper, we will underline a particularly underestimated eating disorder: diabulimia, then that the perception of itself is not only related to the sex assigned at birth, but also to the gender that is acquired during life, and we will also analyze the three phases related to the acquisition of gender identity during the evolutionary period. Finally, we will talk about the use of technology in diabetic patients (insulin pumps, continuous glucose monitoring variably integrated into each other) that might generate a series of psychological–behavioral reactions related to the integration between technology and body image and the experience of social acceptance of the individual, particularly in the evolution age. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
10 pages, 815 KiB  
Article
Sex-Gender Differences in Diabetic Retinopathy
by Sara Cherchi, Alfonso Gigante, Maria Anna Spanu, Pierpaolo Contini, Gisella Meloni, Maria Antonietta Fois, Danila Pistis, Rosangela M. Pilosu, Alessio Lai, Salvatore Ruiu, Ilaria Campesi and Giancarlo Tonolo
Diabetology 2020, 1(1), 1-10; https://doi.org/10.3390/diabetology1010001 - 20 Apr 2020
Cited by 14 | Viewed by 6835
Abstract
Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 [...] Read more.
Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 diabetic patients (T2DM). 20,611 T2DM regularly attending the units for the last three years were classified as having: (a) No DR (NDR), (b) nonproliferative DR (NPDR), or (c) preproliferative/proliferative DR (PPDR). DR of all grades was present in 4294 T2DM (20.8%), with a significant higher prevalence in men as compared to women (22.0% vs. 19.3% p < 0.0001). Among DR patients, both NPDR and PPDR were significantly more prevalent in men vs. women (p = 0.001 and p = 0.0016, respectively). Women had similar age and BMI, but longer diabetes duration, worse glycemic metabolic control, and more prevalence of hypertension and chronic renal failure (CRF) of any grade vs. men. No significant differences between sexes were evident in term of drug therapy for diabetes and associate pathologies. Conclusions: In this large sample of T2DM, men show higher prevalence of DR vs. women, in spite of less represented risk factors, suggesting that male sex per se might be a risk factor for DR development. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
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Review

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10 pages, 287 KiB  
Review
Why We Need Sex-Gender Medicine: The Striking Example of Type 2 Diabetes
by Giuseppe Seghieri, Flavia Franconi and Ilaria Campesi
Diabetology 2022, 3(3), 460-469; https://doi.org/10.3390/diabetology3030034 - 11 Aug 2022
Cited by 7 | Viewed by 2593
Abstract
Type 2 diabetes mellitus is a widespread and a chronic disease associated with micro- and macrovascular complications and is a well-established risk factor for cardiovascular disease, which are among the most important causes of death in diabetic patients. This disease is strongly affected [...] Read more.
Type 2 diabetes mellitus is a widespread and a chronic disease associated with micro- and macrovascular complications and is a well-established risk factor for cardiovascular disease, which are among the most important causes of death in diabetic patients. This disease is strongly affected by sex and gender: sex-gender differences have been reported to affect diabetes epidemiology and risk factors, as well as cardiovascular complications associated with diabetes. This suggests the need for different therapeutic approaches for the management of diabetes-associated complications in men and women. In this review, we describe the known sex-gender differences in diabetic men and women and discuss the therapeutic approaches for their management. The data reported in this review show that a sex-gender approach in medicine is mandatory to maximize the scientific rigor and value of the research. Sex-gender studies need interdisciplinarity and intersectionality aimed at offering the most appropriate care to each person. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
5 pages, 194 KiB  
Review
Gender Difference in Type 1 Diabetes: An Underevaluated Dimension of the Disease
by Patrizio Tatti and Singh Pavandeep
Diabetology 2022, 3(2), 364-368; https://doi.org/10.3390/diabetology3020027 - 20 Jun 2022
Cited by 4 | Viewed by 7743
Abstract
Gender difference in all fields of medicine and biology has recently become a topic of great interest. At present, most studies report gender differences in their secondary analysis; however, this information receives scant attention from clinicians, and is often overwhelmed by press trumpeting [...] Read more.
Gender difference in all fields of medicine and biology has recently become a topic of great interest. At present, most studies report gender differences in their secondary analysis; however, this information receives scant attention from clinicians, and is often overwhelmed by press trumpeting the overall main positive results. Furthermore, and more importantly, any statistical evaluation of results obtained without specific and careful planning in the study for the topic of research is probably worthless. There are few studies in animals, but these are not typically useful because of the different biology, pharmacodynamics and pharmacokinetics compared to humans. Type 1 diabetes is a disease where gender difference can be easily evaluated. Irrespective of the cause of the loss of pancreatic beta-cell function, the common denominators of all forms of type 1 diabetes are the absence of circulating insulin and a reduction in peripheral insulin sensitivity leading to exogenous injections being required. Consequently, exogenous insulin infusion, with any of the widely used research tools, such as the insulin–glucose clamp, can be easily used to evaluate gender difference. Female patients with type 1 diabetes have many factors that impact glucose level. For example, the hormones that drive the ovulatory/menstrual cycle and the connected change at the time of the menopause have a role on insulin action; thus, one should expect great research emphasis on this. On the contrary, there is a dearth of data available on this topic, and no pump producer has created a gender-specific insulin infusion profile. Patients are usually approached on the basis of their diagnosis. This review is intended to focus on personalized treatment, more specifically on gender, according to the modern way of thinking. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
11 pages, 637 KiB  
Review
Sexual Dysfunction in Diabetic Women: An Update on Current Knowledge
by Federica Barbagallo, Laura M. Mongioì, Rossella Cannarella, Sandro La Vignera, Rosita A. Condorelli and Aldo E. Calogero
Diabetology 2020, 1(1), 11-21; https://doi.org/10.3390/diabetology1010002 - 10 Sep 2020
Cited by 6 | Viewed by 6351
Abstract
Diabetes mellitus (DM) is one of the most common chronic diseases worldwide and its prevalence is expected to increase in the coming years. Therefore, updated knowledge of all diabetic complications and their management is essential for the proper treatment of these patients. Sexual [...] Read more.
Diabetes mellitus (DM) is one of the most common chronic diseases worldwide and its prevalence is expected to increase in the coming years. Therefore, updated knowledge of all diabetic complications and their management is essential for the proper treatment of these patients. Sexual dysfunctions are one of the long-term complications of DM in both genders. However, female sexuality is still a taboo and sexual concerns are often overlooked, underdiagnosed, and untreated. The aim of this review is to summarize the current knowledge on the relationship between sexual function and DM in women. In particular, we evaluated the prevalence, etiology, diagnostic approaches, and current treatment options of female sexual dysfunction (FSD) in diabetic patients. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
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Other

6 pages, 209 KiB  
Commentary
Gender Differences in Migration
by Francesca Ena
Diabetology 2022, 3(2), 328-333; https://doi.org/10.3390/diabetology3020023 - 5 May 2022
Cited by 1 | Viewed by 2014
Abstract
There are about 200 million people on the move in the world, and approximately 50% of them are women. There are no clear migration plans for women leaving as a result of persecution, war, famine, climatic disasters or moving away from contexts of [...] Read more.
There are about 200 million people on the move in the world, and approximately 50% of them are women. There are no clear migration plans for women leaving as a result of persecution, war, famine, climatic disasters or moving away from contexts of external abuse and even intrafamily violence. Gender-related violence, to which women are exposed in cultural contexts characterized by a patriarchal social organization, is manifested through different ways including, but not limited to, early marriages and genital mutilation, with reproductive health already being seriously impaired at an early age. To this must be added the consideration that low-income countries are not able to deal with chronic degenerative diseases with a multidisciplinary approach such as diabetes. Fragile or non-existent health systems are not prepared for this need, which now affects a third of all deaths from this cause. Compared to Italian mothers, women from high-migration pressure countries had a higher risk of gestational diabetes; in addition, young women of Ethiopian ethnicity are more exposed to increased diabetes risk, in an age- and BMI-dependent way. Gender inequalities are also more evident in migrants for other non-communicable diseases besides diabetes. A major effort is needed in terms of training practitioners and reorganization of basic health services, making them competent in an intercultural sense. Health education of the population as a whole and of women specifically is also needed to contain risk behavior and prevent the early onset of metabolic syndromes in general and of type 2 diabetes in particular. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
8 pages, 438 KiB  
Commentary
Erectile Dysfunction in Diabetic Patients: From Etiology to Management
by Rossella Cannarella, Federica Barbagallo, Rosita A. Condorelli, Carmelo Gusmano, Andrea Crafa, Sandro La Vignera and Aldo E. Calogero
Diabetology 2021, 2(3), 157-164; https://doi.org/10.3390/diabetology2030014 - 4 Sep 2021
Cited by 4 | Viewed by 4430
Abstract
Diabetes mellitus (DM) is a widespread chronic disease with a prevalence that is expected to further increase in the near future. The classical management of DM includes the normalization of the glycometabolic profile and the evaluation of cardiac and cerebral vascular health by [...] Read more.
Diabetes mellitus (DM) is a widespread chronic disease with a prevalence that is expected to further increase in the near future. The classical management of DM includes the normalization of the glycometabolic profile and the evaluation of cardiac and cerebral vascular health by the intervention of an array of different specialists. However, so far, sexual dysfunctions are still a neglected complication in patients with DM, although there is an elevated prevalence of this long-term complication in male and female patients. Furthermore, some of them may represent a sign of vascular alteration and/or hypogonadism and require timely management to prevent the onset of major adverse cardiac events. This narrative review briefly summarizes the current evidence on epidemiology, pathogenesis, diagnosis, and therapy of erectile dysfunction in male patients with DM to support diabetologists in clinical practice. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
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6 pages, 189 KiB  
Commentary
Sex-Gender Awareness in Diabetes
by Giancarlo Tonolo
Diabetology 2021, 2(2), 117-122; https://doi.org/10.3390/diabetology2020010 - 21 Jun 2021
Cited by 7 | Viewed by 3748
Abstract
Sex and gender can affect incidence, prevalence, symptoms, course and response to drug therapy in many illnesses, being sex (the biological side) and gender (the social-cultural one), variously interconnected. Indeed, women have greater longevity; however, this is accompanied by worse health than men, [...] Read more.
Sex and gender can affect incidence, prevalence, symptoms, course and response to drug therapy in many illnesses, being sex (the biological side) and gender (the social-cultural one), variously interconnected. Indeed, women have greater longevity; however, this is accompanied by worse health than men, particularly when obesity is present. Sex-gender differences are fundamental also in both type 1 and type 2 diabetes. Just for example in the prediabetes situation impaired fasting glucose (expression of increased insulin resistance) is more common in men, while impaired glucose tolerance (expression of beta cell deficiency) is more common in female, indicating a possible different genesis of type 2 diabetes in the two sexes. In type 1 diabetes male and female are equivalent as incidence of the disease since puberty, while estrogens act as protective and reduce the incidence of type 1 diabetes in female after puberty. Considering macrovascular complications, diabetic women have a 3.5 fold higher increased cardiovascular risk than non diabetic women, against an observed increase of “only” 2.1 fold in male. Thus it is clear, although not fully explained, that sex-gender differences do exist in diabetes. Another less studied aspect is that also physician gender influences quality of care in patients with type 2 diabetes, female physicians providing an overall better quality of care, especially in risk management. The goal of this short commentary is to open the special issue of Diabetology: “Gender Difference in Diabetes” leaving to the individual articles to deepen differences in genesis, psychologists aspects and complications of the disease. Full article
(This article belongs to the Special Issue Gender Difference in Diabetes)
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