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Diabetes: Why Men with Obesity Face Higher Risks

In the complex web of factors that contribute to the development of type 2 diabetes, a new study has shed light on a crucial piece of the puzzle…

The role of sex differences in adipose tissue insulin resistance.

The findings, presented at the European Congress on Obesity (ECO) 2024 and published in the International Journal of Obesity, offer valuable insights into why men with obesity are more prone to developing type 2 diabetes than women.

Let’s take a look at the results, and what it could mean for your or your loved one.

The research team set out to investigate the functional differences between men and women when it comes to insulin’s role in subcutaneous abdominal fat storage and release.

Their findings reveal a striking disparity that could have far-reaching implications for the prevention and treatment of type 2 diabetes.

The study involved measuring the adipose insulin resistance index (AdipolR) in the subcutaneous abdominal fat of 2,344 women and 787 men with a mean age of 44 years and a mean BMI of 35. (The adipose insulin resistance index is a measure of how well or poorly the fat tissue in your body responds to insulin, a hormone that helps control blood sugar levels.)

The results were clear: men had significantly higher AdipoIR values than women, but only in those with a BMI of 30 or above, indicating obesity. This pattern held true regardless of the participants’ physical activity levels, presence of cardiometabolic disease, or nicotine use.

To delve deeper into these differences, the researchers isolated adipocytes from biopsies in a subgroup of 259 women and 54 men living with obesity.

They discovered that a staggering 10-fold higher concentration of insulin was needed to block the breakdown of triglycerides to fatty acids in men compared to women, and the blockage was also less effective in men.

When someone has insulin resistance, their body has trouble using insulin properly. Insulin is a hormone that helps control blood sugar levels.

In a healthy person, insulin stops the breakdown of fatty acids and helps store them. However, when someone is insulin resistant, there is less control over this process. This means that more fatty acids end up in the bloodstream.

Having too many fatty acids in the blood for a long time can cause problems in different parts of the body. It can make it harder for muscles to take in sugar from the blood. It can also cause the liver to produce more sugar.

Additionally, the pancreas might not be able to produce enough insulin.

All of these issues work together to create a cycle that’s hard to break. Blood sugar levels stay high, which makes it even harder for the body to use insulin effectively. At the same time, more fatty acids are released into the blood from fat cells. This cycle keeps repeating itself, leading to the development of type 2 diabetes.

This study shows that men and women with obesity may need different strategies for preventing and treating health problems. Men seem to have more insulin resistance in their belly fat compared to women.

An expert in obesity and health complications says that this finding is important as it shows there are clear differences between men and women when it comes to how obesity affects health—and it helps us understand the biology behind these differences.

However, it also makes us think about what we can do to improve insulin sensitivity and lower the risk of getting type 2 diabetes. While medications and weight loss surgery can help, there are also other ways to make a big difference without using drugs.

Engaging in regular physical activity, for example, has been shown to improve insulin sensitivity by increasing muscle glucose uptake and reducing the accumulation of fat in the liver. Adopting a balanced, nutrient-dense diet that is low in processed foods and high in fiber, healthy fats, and lean proteins can also help regulate blood sugar levels and promote healthy adipose tissue function.

Additionally, managing stress through techniques like mindfulness, meditation, and deep breathing can help reduce the production of stress hormones like cortisol, which can contribute to insulin resistance and abdominal fat accumulation.

To a healthier, more resilient future,

Rachel Mace
Managing Editorial Director, e-Alert
with contributions from the research team

P.S. The spicy secret to taming type 2 diabetes.


Daniel P. Andersson et al. (2024). Adipose tissue insulin resistance and insulin-stimulated lipid storage capacity in men versus women with obesity. International Journal of Obesity.

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