title: Sex-specific differences in diabetes prevention: a systematic review and meta-analysis.
abstract: OBJECTIVE
  In people with prediabetes, lifestyle interventions and glucose-lowering medications are effective in preventing the progression to type 2 diabetes. It is unclear whether differences in treatment effects between men and women need to be taken into consideration when choosing a preventive strategy for an individual person.
  
  
  METHODS
  We systematically searched PubMed, the Cochrane Library, EMBASE, CINAHL, Web of Science, and reference lists of pertinent review articles from 1980 to June 2013. We conducted random effects meta-analyses of published and unpublished data to determine differences of treatment effects between men and women.
  
  
  RESULTS
  Twelve randomised control trials (RCTs) provided sex-specific information on treatment effects. Compared with usual care, men and women who received lifestyle interventions had a lower rate of progression to type 2 diabetes (RR 0.60 [95% CI 0.35, 1.05] after 1 year; RR 0.63 [95% CI 0.51, 0.79] after 3 years); greater weight reduction (-2.45 kg; [95% CI -3.56, -1.33 kg] after 3 years); and greater reductions of fasting plasma glucose (-0.31 mmol/l [95% CI -0.48, -0.15] after 3 years) and 2 h post-challenge-glucose (-0.68 mmol/l [95% CI -1.03, -0.34] after 3 years). No statistically significant differences in treatment effects between men and women were apparent for any outcomes (p values of all comparisons ≥ 0.09).
  
  
  CONCLUSIONS
  Our study emphasises the importance of preventive interventions in people with prediabetes and indicates no differences of beneficial preventive effects on the incidence of type 2 diabetes and weight gain between men and women.
authors.affiliation: Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500, Krems, Austria, anna.glechner@donau-uni.ac.at.
authors.forename: Anna
authors.initials: A
authors.lastname: Glechner
authors.forename: Jürgen
authors.initials: J
authors.lastname: Harreiter
authors.forename: Gerald
authors.initials: G
authors.lastname: Gartlehner
authors.forename: Sonja
authors.initials: S
authors.lastname: Rohleder
authors.forename: Alexander
authors.initials: A
authors.lastname: Kautzky
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Megan
authors.initials: M
authors.lastname: Van Noord
authors.forename: Angela
authors.initials: A
authors.lastname: Kaminski-Hartenthaler
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D011236:Prediabetic State / Q000453:epidemiology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior; D012737:Sex Factors; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin