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Introduction

Diabetes is an important risk factor. It is estimated that the number of diabetic patients will reach 552 million by 2030 [1, 2]. Diabetic eye disease and nephropathies are common diabetic complications, that can lead to blindness and renal failure [3-5]. In addition, diabetes is also significantly related to the occurrence, death and all-cause mortality of cerebrovascular diseases, making it a serious economic burden for individuals and society. Type 2 diabetes affects both the male and female, and is highly associated with morbidity, mortality, and a high health cost to individual patients, their families, and countries [6, 7].

The present study aimed to study the gender differences in BMI, clinical characteristics and glycemic control among type 2 diabetes mellitus (T2DM) patients.

Methodology

This prospective, cross-sectional study was conducted at Department of Pharmacology in collaboration with Department of Medicine, Rama Medical College & Research Hospital during March 2022 to August 2022 comprising a sample size of 100 newly diagnosed T2DM patients. The study has been approved by the institutional ethical committee. The adults T2DM patients aged between 30 and 65 years of both genders were included in the study. Already known diabetics, pregnant women and those who are not willing to provide informed consent or participation in study were excluded from the study. The included patient’s demographic data was collected. The blood samples were collected into vacutainer with standard procedures and analyzed for FBS, PPBS, HBA1c, fasting insulin and c-peptide levels to evaluate the glycemic control [8]. BMI was calculated using standard method [9]. HOMA-IR was calculated using previously described method [10]. Male preponderance and age‑wise increase in prevalence noted as per the study [11]. The clinical symptoms (polydipsia, polyuria, polyphagia) incidence was in line with previous study [12].

Statistical analysis

The data was analyzed using SPSS software version 21.0. The data was expressed in frequency (N), percentage, mean, standard deviation and student’s t-test was used for significance. p value of 0.5 has been taken as statistically significant.

Results

This study included 100 newly diagnosed T2DM patients. Current data on clinical characteristics and gender differences in diabetes are limited. In our study, there was male preponderance and age‑wise increase in prevalence noted, which have been reported in previously in numerous studies. The mean age between the genders was comparable (p>0.05). Majority of female patients had BMI more 30 kg/m2 and majority of male had normal BMI. The glycemic parameter was comparable between both genders. Majority of female patients were having BMI > 30 kg/m2 and male patients had < 29 kg/m2. Past family history of diabetes was seen in 56% female patients (Table 1).

Table 1: Demographic details of study participants.  

N- total number, n- incidence, percentage, SD-standard deviation. Polydipsia, polyphagia and polyuria incidence was more in male patients. Marginal variations were seen with other clinical symptoms. Fatigue was more in female patients (Figure 1).

Figure 1: Clinical characteristics of study participants.

The glycemic parameters were comparable among the study groups. Studies including larger population size may show better relationships between the glycemic parameters and study participants (Table 2).

Table 2: Glycemic parameters between genders. SD- standard deviation, significance was obtained using student’s t test.  

During the study period, only 100 patients were enrolled into the study and the gender distribution was not comparable. Yet the study was continued to study the clinical characteristics among the available study samples which may be considered as limitations of the study.

Discussion

Gender differences in the clinical presentation of newly diagnosed T2DM patients at a tertiary care hospital highlight distinct symptom patterns between males and females. Men were more likely to be diagnosed at a younger age, potentially due to higher exposure to modifiable risk factors like smoking, alcohol consumption, and sedentary lifestyles. Women, on the other hand, were diagnosed at a later age, often with more advanced complications such as neuropathy or retinopathy. This delay is often attributed to lower health awareness and socioeconomic constraints impacting timely access to care [13].

Obesity and waist-to-hip ratio were found to be higher in women, indicating a stronger association between central adiposity and diabetes risk in females. Men tended to present with higher fasting glucose levels and lipid abnormalities at diagnosis, suggesting a predisposition to metabolic syndrome. Hormonal factors, such as the protective role of estrogen in premenopausal women, might delay the onset of diabetes, whereas postmenopausal women exhibited higher susceptibility.

Females were found to have a higher incidence of balanitis, attributed to recurrent infections due to poor glycemic control. Similarly, burning micturition was more common among females, likely linked to higher rates of urinary tract infections and delayed healthcare-seeking behavior. Fatigue was also reported more frequently by females, potentially due to anemia, hypothyroidism, or greater psychological stress associated with caregiving roles [14].

Conversely, males exhibited distinct symptomatology, including a higher prevalence of burning sensations in the legs and eyes. Peripheral neuropathy leading to burning sensations in the legs might be more pronounced in males due to a combination of vascular complications and earlier onset of nerve damage [15]. Dry mouth, polyphagia, polyuria, and polydipsia were also more commonly reported in males, reflecting their tendency toward more severe hyperglycemia at diagnosis. Nocturia was particularly prevalent in males, potentially linked to prostate-related issues in addition to diabetes [16].

These gender-specific differences in symptomatology underscore the need for tailored approaches to diagnosis and treatment. For instance, females may benefit from improved screening for urinary and genital infections, as well as interventions addressing fatigue and overall health awareness. In contrast, males may require earlier screening for neuropathy and glycemic control strategies to mitigate hyperglycaemia-related symptoms [17].

The findings also highlight the role of social, cultural, and biological factors in shaping the presentation of T2DM. Gender-sensitive education programs aimed at raising awareness about specific symptoms could aid in early detection and management. Understanding these differences can guide clinicians in adopting a holistic approach to diabetes care that considers the unique needs of both men and women [18, 19].

Conclusion

The study concludes with significant BMI differences between male and female T2DM patients. Patients with these characteristics require special consideration, and health-care providers must be conscious of the possible complications of patient subgroups based on clinical characteristics of DM. Clinical management in DM care should include attempts to symptomatic therapies in this regard.

Conflicts of interest

Authors declare no conflicts of interest.