Sex- and gender-differences in chronic long-term complications of type 1 and type 2 diabetes mellitus in Italy

This review summarizes the contribution of Italian diabetologists devoted to a better understanding of the complex relationship linking sex/gender and long-term complications of type 1 (T1DM) and type 2 diabetes (T2DM) over the last fifteen years. Microvascular and macrovascular complications of diabetes show sex- and gender-related differences, involving pathophysiological mechanisms, epidemiological features and clinical presentation, due to the interaction between biological and psychosocial factors. These differences greatly impact on the progression of diabetes and its long-term complications, especially in the cardiovascular, renal and liver districts. A better knowledge of such sex- and gender-related characteristics is required for a more precise patient phenotypization, and for the choice of a personalized antihyperglycemic treatment. Despite such mounting evidence, current diabetes clinical guidelines do not as yet adequately consider sex/gender differences. •In Italy, macrovascular and microvascular complications of diabetes show different prevalence and clinical characteristics according to sex.•Such sex disparities are robust social determinants of health.•Updated epidemiologic and prognostic information coming from sex-specific studies are still needed.