Diabetes care must widen focus, adapt to risks

Type 2 diabetes is routinely treated as a blood-sugar disease, managed through monitoring glucose, weight, blood pressure and cholesterol. A new study published in PLOS Medicine suggests that this approach misses an important aspect: The disease does not follow quite the same path in men and women. Researchers followed nearly 30,000 people diagnosed with Type 2 diabetes in England between 2010 and 2020 and found that men were more likely to develop cardiovascular disease and end-stage kidney disease, and that they generally reached such complications earlier. Women, meanwhile, were likelier to develop anxiety, depression and other mental-health conditions. Hypertension was the most common complication for both sexes and across all age groups. While part of the gap in mental-health diagnoses could reflect differences in how readily men and women seek care, the study exposes the limits of treating a varied disease with a standard template. For India, which carries one of the world's heaviest diabetes burdens — more than 101 million Indians live with diabetes and a further 136 million with prediabetes — this has strong implications. A 2026 meta-analysis of Indian studies, published in Diabetology and Metabolic Syndrome, found that 38 per cent people with Type 2 diabetes show signs of depression. Another pooled analysis in the Journal of Diabetes and Metabolic Disorders published earlier this year estimates those affected by anxiety at roughly three in 10. These suggest that a large number of diabetes patients in the country are carrying an unaddressed mental burden alongside a physical one. These findings make a strong case for broadening diabetes care beyond its traditional focus on physical risk factors. Treatment should pay closer attention to individual patients, irrespective of their sex, recognising that age, family history, lifestyle, duration of diabetes and access to healthcare have critical impact on outcomes. Primary-care doctors and diabetes clinics should be equipped to recognise mental-health needs and conduct simple screening for anxiety and depression, referring to specialists when necessary. At the same time, greater attention should be paid to regular cardiovascular and kidney assessment in men, without assuming that women are protected from these complications or that men are immune to psychological distress. As the country's diabetes burden continues to grow, treating the condition as something that affects the mind as well as the body could mark a meaningful shift towards more effective care.