Gender-specific Effects of Treatment with Lifestyle, Metformin or Sulfonylurea on Glycemic Control and Body Weight: A German Multicenter Analysis on 9 108 Patients

Effects of diabetes treatment are strongly connected to individual factors, but the relevant role of gender has not been addressed so far. This observational study evaluates whether monotherapy with lifestyle, metformin or sulfonylurea has gender-specific effects on glycemic control and/or body weight. Data of 9 108 patients with type 2 diabetes from 129 German diabetes centers were assessed by a standardized, prospective, computer-based diabetes care and outcome docu-mentation system (DPV-Wiss-database; age 63.1 +/- 12.8 years, diabetes duration 5.7 +/- 7.4 years, HbA1c 55 +/- 17.7 mmol/mol [7.2 +/- 1.6 %], BMI 30.6 +/- 6.1 kg/m(2), 49.3 % female patients). Antidiabetic concepts included lifestyle intervention (n = 5,787), metformin (n = 2,180), sulfonylurea (n = 943) or other antidiabetic drugs (n = 198), respectively. HbA1c and body weight were compared before and after a stable monotherapeutical period of 0.8 +/- 0.4 years. Women had a significantly higher reduction of body weight after treatment with lifestyle (women -0.8 +/- 0.1 vs. men -0.2 +/- 0.1 kg; p < 0.05), metformin (women -1.8 +/- 0.2 vs. men -1.2 +/- 0.2 kg; p < 0.05) or sulfonylurea drugs (women -0.9 +/- 0.2 vs. men -0.1 +/- 0.2 kg; p < 0.05), whereas men displayed significantly higher HbA1c-reductions after treatment with lifestyle (women -6.9 +/- 0.2 mmol/mol [-0.6 +/- 0.02 %] vs. men -7.5 +/- 0.2 mmol/mol [0.7 +/- 0.02 %]; p < 0.05) and metformin only (women -6.3 +/- 0.3 mmol/mol [-0.6 +/- 0.03 %] vs. men -7.4 +/- 0.3 mmol/mol [-0.7 +/- 0.03 %]; p < 0.05). No differences were seen for sulfonylurea monotherapy concerning the HbA1c-reduction (women -5.6 +/- 0.5 mmol/mol [-0.5 +/- 0.05 %] vs. men -6.4 +/- 0.4 mmol/mol [-0.6 +/- 0.04 %]; p = 0.196). In summary, antidiabetic treatment concepts might result in gender-specific effects on body weight and HbA1c. Gender might therefore represent another important factor in the context of an individualized treatment management of type 2 diabetes.