title: Sex-gender differences in diabetes vascular complications and treatment.
abstract: Diabetes mellitus and cardiovascular diseases act as two sides of the same coin: diabetes is an important risk factor for cardiovascular disease while patients with ischemic cardiovascular diseases often have diabetes or pre-diabetes. As firstly shown by Framingham study, diabetic women have an increased cardiovascular risk about 3.5 fold higher than non diabetic women, against an increase of "only" 2.1 fold found in male subjects. In view of the impact of sexual hormones on glucose homeostasis, the molecular pathways involved in insulin resistance suggest a sex-gender specificity mechanism in the development of diabetic complications leading to the unmet need of sex-gender therapeutic approaches. This has also been seen in other diabetic complications such as renal diseases, which seems to progress at a faster rate in females compared with males and women benefit less from treatment than do men. Of note, none of the trials done so far are primarily designed to assess sex-gender differences in the benefit from a specific intervention strategy, de facto excluding fertile women from experimentation. In order to provide a more evidence based medicine for women and to reach equity between men and women, sex-gender epidemiological reports, preclinical and clinical research are mandatory to evaluate the impact of gender on the outcomes and to improve sex-gender awareness and competency in the health care system. Future studies should consider sex-gender differences in the setting of randomized controlled trials with drugs.
authors.affiliation: Center for Biotechnology Development and Biodiversity Research and Department of Biomedical Science, University of Sassari, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Franconi
authors.forename: Ilaria
authors.initials: I
authors.lastname: Campesi
authors.forename: Stefano
authors.initials: S
authors.lastname: Occhioni
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tonolo
mesh_terms: D000375:Aging / Q000378:metabolism; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D003929:Diabetic Neuropathies / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics; D015995:Prevalence; D012737:Sex Factors
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents