The Role of Female Sex and Gender in Personalised Diabetes Management: An Overlooked Perspective

Sex and gender play a significant role in shaping the presentation, management, and outcomes of diabetes mellitus (DM). There is increasing recognition that physiological differences, treatment responses, risk of complications, and access to healthcare resources differ significantly between men and women, contributing to variations in vulnerability, disease progression, and outcomes. This review examines the current understanding of sex- and gender-based differences in glycaemic and metabolic control, acute and chronic diabetes-related complications, therapeutic efficacy, and adverse events. It also explores how disparities in socioeconomic status, self-care behaviours, healthcare access, and mental health burdens influence diabetes prevention and management across genders. Recognising these disparities, we provide evidence-based recommendations to guide personalised and gender-sensitive approaches to diabetes care, focusing on addressing women's unique challenges. These recommendations include the need for equitable treatment practices, targeted interventions, and culturally appropriate prevention strategies. Finally, we emphasise the importance of promoting inclusive research practices and advocating for large-scale prospective studies and clinical trials that account for sex and gender differences to improve outcomes for all individuals living with diabetes.