CVM Cardiovascular Medicine 1664-204X 1664-2031 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 02273 10.4414/cvm.2023.02273 Review article Epidemiology Sex differences in type 2 diabetes Estoppey Paco School of Medicine, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland | SWITZERLAND Clair Carole Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland | SWITZERLAND Auderset Diane Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland. | SWITZERLAND Puder Jardena Jacqueline Jardena.Puder@chuv.ch Department of Medicine | Division of Endocrinology, Diabetes and Metabolism | BH 19709 | Centre Hospitalier Universitaire Vaudois | Lausanne | 1011 | SWITZERLAND 17 05 2023 26 03 96 99 Copyright: EMH Schweizerischer Ärzteverlag AG 2023 EMH Schweizerischer Ärzteverlag AG "Cardiovascular Medicine" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

The influence of sex – considered to be the biological differences between women and men – and gender – considered to be sociologically constructed differences based on membership in one of the two sex categories – appears to be particularly important for noncommunicable diseases such as type 2 diabetes (T2D) and obesity. Many T2D risk factors are behavioral and greatly, but not only, influenced by gender-related determinants, making them modifiable factors. In this review, we focus on sex-related biological differences in the prevalence of diabetes and its biological risk factors, such as obesity, fat distribution, metabolic syndrome, and glucose homeostasis, with a particular interest in the influence of menopause and pregnancy. Men have had globally a higher prevalence of T2D than women with regional, socioeconomic, and age-related variations. Overall, women tend to be more protected from cardiometabolic diseases before menopause than men. However, hormonal variation during the course of life, particularly during menopause, modifies these risks. Similarly to T2D,  there are differences in the prevalence of obesity between women and men that change during the lifespan. The link between obesity and T2D seems to be stronger in women compared to men. Various hormones can impact on glycemic levels and on body fat and their concentrations and effect on metabolic parameters can differ by sex. Understanding and acknowledging sex-related differences in T2DM and its risk factors is important to improve health research and lead to better clinical care and more suitable preventive policies and programs for both women and men.