Sex-specific differences in diabetes prevention: a systematic review and meta-analysis

Abstract

Aims/hypothesis: 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 We conducted random effects meta-analyses of published and unpublished data to determine differences of treatment effects between men and women. Conclusions/interpretation: 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. 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).