Table 1.

Sex Dimorphism in Diabetes Risk Factors

Risk Factors	Diabetes Risk		Notes	Reference
	Men	Women
BMI	+	+	Men: diabetes diagnosis at lower BMI	9, 13, 15, 18, 25
			Stronger obesity-diabetes risk association in women
			Better predictor of T2DM in men
WCR	+	++	Better predictor of T2DM in women	23–25
			More prominent increase with increasing age in women
Clustering of metabolic risk factors, MetS	+	+	Similar prevalence but sex-dimorphic clustering of risk factors: higher prevalence of hypertension and adiposity in women and of low HDL-cholesterol and higher uric acid levels in males; in younger subjects, the combination of dyslipidemia with increased WCR was most prevalent in females but with hypertension in males	34–36
No-leisure time physical activity (LTPA)	+	++	Greater impact on obesity and closer association with increased abdominal adiposity in women than men	119–123
Prediabetes	+	+		82
IFG	++	+	Men: More often (isolated) impaired fasting glucose (highest rates, 50–70 y)
IGT	+	++	Women, more often (isolated) IGT (until 80 y)
Higher testosterone	−	+	Metaanalysis: 60% higher diabetes risk in women, 42% lower diabetes risk in men	71
			Sexual-dimorphic risk of hyperandrogenism
Low SHBG	+	++	Stronger association with diabetes risk in women	60, 61
			SHBG gene polymorphisms relate to diabetes risk
			Hyperinsulinemia and increased liver fat strongly relate to low circulating SHBG
Previous GDM	n.a.	++	71% higher incidence of T2DM among prediabetic women	85, 86
			Metaanalysis: 7-fold greater risk of development of T2DM compared with women who maintained NGT during pregnancy
PCOS	n.a.	2+	4-fold higher risk for T2DM	73
Shift work (related to sleep deprivation)			Overall, controversial results, sex-dimorphic impact of chronotypes
	++	+	Greater diabetes risk in men in a metaanalysis	106–108
	+	++	Greater diabetes risk in women in other studies: in women, BMI mainly influenced the association with T2DM	103–105
			Greater association of night-work exposure and incident T2DM in women in some studies
Job strain
High work demands	−	0	Protective in men	100
Low decision latitude	0	+	Higher diabetes risk in women, particularly greater in combination with high demands	100
High straina	0	+	Lower diabetes risk in nonobese men and higher diabetes risk in obese women	100–102
Active jobb	−	0	Protective in men	100
Low education	0	+	Higher diabetes risk in women	93
High occupation	0	−	Occupation, women's autonomy, and empowerment appear more protective against obesity for women than education on its own	95, 349
Low SES	+	++	Inverse association between SES and prevalence of obesity and diabetes in developed countries with stronger association in women, especially in white young women	10
Low childhood SES	0	+		98
Smoking	+	+	Comparably increased diabetes risk, but 25% greater increase of cardiovascular risk in women	134, 138

0, no effect; −, decreases diabetes risk; +, increases diabetes risk; ++, increases diabetes risk to a greater extent; n.a., nonappropriate.

^aHigh demand with low decision latitude.

^bHigh demand with high decision latitude.