Diabetes isn't gender-neutral, but it's still being treated that way. Hormonal shifts across a woman's life — from menstrual cycles to menopause — significantly affect insulin needs and cardiovascular risk, yet women remain underrepresented in research and undertreated in practice. Experts are calling for sex-specific diabetes care as a form of precision medicine.
Diabetes care has a gender problem. According to Dr. Susanne Reger-Tan, a leading diabetologist in Germany, hormonal changes throughout a woman's life — including the menstrual cycle, pregnancy, and menopause — meaningfully alter insulin sensitivity, glucose regulation, and cardiovascular (CV) risk. Yet clinical guidelines and treatment protocols largely ignore these differences, leaving many women with suboptimal care.
Conditions like polycystic ovary syndrome (PCOS, now termed PMOS) and gestational diabetes serve as early red flags: PMOS affects 1 in 8 women and dramatically raises the risk of type 2 diabetes and CV disease, while gestational diabetes increases the subsequent risk of type 2 diabetes sevenfold to tenfold — yet up to 70% of PMOS cases go undiagnosed. During menopause, unpredictable estrogen fluctuations cause greater glycemic variability, and hot flashes can dangerously mimic hypoglycemia symptoms.
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Why it matters: The gender data gap in diabetes research isn't just an equity issue — it has real clinical consequences. Closing it through better representation in trials, earlier recognition of sex-specific risk markers, and equitable prescribing of proven therapies could meaningfully reduce complications for millions of women.
