Diabetes is a global health issue, but men face unique risks and complications when it comes to this chronic condition. Scientific research highlights both biological and behavioral factors that influence how diabetes affects men differently from women.

Higher Prevalence and Risk Factors

When examining gender differences, evidence shows their existence in risk factors for T1D, T2D and prediabetes.

Research shows a male predominance in type 1 diabetes incidence after puberty. This pattern of higher incidence in males persists across most age groups and has been observed in several countries. The reasons behind this male predominance are not fully understood, but hypotheses include differences in environmental risk factors, genetic susceptibility, and hormonal influences after puberty.1 

Studies show that men are more likely to develop type 2 diabetes at a lower body mass index (BMI) compared to women. This is largely because men tend to accumulate more abdominal fat, which is a significant risk factor for insulin resistance and diabetes. In a large cohort, the prevalence of type 2 diabetes was 14.6% in men versus 9.1% in women, with central obesity being a key driver of this disparity2. 

Men’s tendency to store fat in the abdomen rather than the hips increases their risk, even if their overall weight is not considered obese by standard measures3.

Studies consistently demonstrate a higher prevalence of prediabetes in men compared to women. Factors associated with prediabetes in men include BMI, triglycerides, and age4.

Complications: More Severe for Men

Men with diabetes are at higher risk for serious complications. They are 51% more likely to develop cardiovascular disease, 47% more likely to experience leg and foot complications, and 55% more likely to have kidney issues compared to women. These elevated risks persist regardless of how long a man has had diabetes5. 

Additionally, men are more likely to experience nerve damage, which can result in urinary issues and sexual dysfunction3.

Sexual Health and Diabetes

One of the most notable complications for men is erectile dysfunction (ED). Up to 75% of men with diabetes report difficulties achieving or maintaining an erection, primarily due to nerve and blood vessel damage caused by high blood sugar. ED can also be an early warning sign of cardiovascular problems and should prompt further medical evaluation3. Other male-specific issues include reduced muscle mass and recurrent genital infection6.

Behavioral Factors and Diagnosis

Men are generally less likely to seek medical care or discuss sensitive health topics, such as sexual dysfunction, with healthcare providers. This reluctance can delay diagnosis and management of diabetes, increasing the risk of severe complications3. Early detection is crucial, especially since treatment for complications is often the first time diabetes is discovered in men6.

Prevention and Management

While some risk factors, such as genetics and age, cannot be changed, lifestyle modifications can significantly reduce the risk and severity of diabetes in men. Regular physical activity, maintaining a healthy weight, and routine health screenings are essential prevention and early intervention strategies.

In Summary

Diabetes doesn't affect everyone equally—men face distinct challenges, from a higher likelihood of developing diabetes at lower weight levels to increased risks for heart issues, nerve damage, and sexual health concerns. But there's good news: by understanding these differences, men can take proactive steps to stay healthy, manage diabetes effectively, and thrive.

1. https://pubmed.ncbi.nlm.nih.gov/39570488/

2. https://academic.oup.com/jcem/article/101/10/3740/2764924?login=false

3. https://www.cdc.gov/diabetes/risk-factors/diabetes-and-men.html

4. https://www.cdc.gov/diabetes/php/data-research/index.html

5. Gibson AA, Cox E, Schneuer FJ, Humphries J, Lee CM, Gale J, Chadban S, Gillies M, Chow CK, Colagiuri S, Nassar N. Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes. J Epidemiol Community Health. 2024 Jul 10;78(8):479-486. doi: 10.1136/jech-2023-221759. PMID: 38755015; PMCID: PMC11287557.

6. https://www.medicalnewstoday.com/articles/311173#diabetes-symptoms-in-men