Men With Type 2 Diabetes Dying Decade Before Women on Same Health Path, UK Study Finds

When someone is diagnosed with Type 2 diabetes, the fears that typically follow tend to center on heart disease or kidney failure. But a large UK study tracking nearly 29,000 patients points to a different danger: among the disease paths researchers tracked, people with diabetes who went on to develop depression, anxiety, or related mental health conditions died at younger ages than those following the other trajectories examined. And for men in particular, death came nearly a decade earlier than it did for women walking that same path.

Type 2 diabetes already affects an estimated 4.3 million people in the United Kingdom alone, with hundreds of thousands more living with the condition undiagnosed. Researchers have long known that diabetes opens the door to a cascade of other serious conditions. But most previous studies examined those complications separately, without tracking the order in which they tend to appear or mapping out how that sequence plays out differently for women versus men. The new study, published in the journal PLOS Medicine, set out to change that, building the first detailed picture of what unfolds, step by step, after a diabetes diagnosis, split by sex and age group.

What emerged from the data is a sharp divergence. Women diagnosed with Type 2 diabetes were considerably more likely to later be diagnosed with a mental health condition such as depression or anxiety. Men, by contrast, were more likely to develop heart disease or kidney failure. Both groups faced earlier death when mental health conditions entered their disease path, but men in that situation died at a median age of 61, compared to 70 for women following the same sequence.

How the Type 2 Diabetes Study Was Conducted

Researchers at Queen Mary University of London used anonymized patient records from a large database drawn from general practices across England. Starting with a source population of nearly 4 million people, they identified 28,720 individuals newly diagnosed with Type 2 diabetes between 2010 and 2020, none of whom had a prior history of the other conditions being tracked.

Researchers followed patients for a median of 6.8 years. Researchers tracked when and in what order each person developed additional conditions, including high blood pressure, heart disease, kidney failure, and mental health conditions, specifically depression, anxiety, and a related category of disorders where psychological distress shows up as unexplained physical symptoms. Death from any cause was also recorded.

Men made up 62% of the group and were typically diagnosed with diabetes at a median age of 54. Women tended to be diagnosed about two years later, at a median age of 56. To capture how age at diagnosis shapes what happens next, researchers divided participants into three groups: those diagnosed between ages 16 and 39, 40 and 59, and 60 and older.

Rather than simply counting who got which disease, the team used a method that tracks how individuals move from one health condition to the next over time. This approach allowed researchers to identify 11 distinct health states and 19 different disease paths, providing a far more detailed picture than any single snapshot could.

What the Numbers Revealed About Men, Women, and Mental Health

Among all participants who developed at least one additional condition after their diabetes diagnosis, the splits between women and men were notable. Women were diagnosed with a mental health condition after diabetes at a rate of 8.1%, compared to 5.3% for men. Men, on the other hand, were diagnosed with heart disease or kidney failure at a rate of 8.4%, compared to 5.3% for women. High blood pressure was the single most common complication across all age groups and both sexes, with about 20 to 21% of both women and men developing it after their diabetes diagnosis.

Younger women, those between 16 and 39 at the time of their diabetes diagnosis, had the highest probability of developing a mental health condition of any group tracked in the study. As women got older, that mental health risk remained elevated compared to men of the same age, though the risk of heart disease and kidney failure grew more prominent with age.

Men, regardless of age group, were more likely to develop heart disease or kidney failure as a next step after their diabetes diagnosis than women in the same age bracket. For men over 60, that likelihood was the single highest probability among all possible next events tracked.

Of every disease path the study mapped, the one running from diabetes to a mental health condition to death ended at the youngest ages for both sexes. It was the deadliest sequence in the data, and it hit men hardest.

Part of the story shows up in how often men and women turned to their doctors. Across nearly all disease paths examined, women had substantially higher rates of healthcare use. On average, women in the overall diabetes group had about 92 primary care consultations over the study period, compared to about 32 for men, along with higher average hospitalization rates. Researchers noted this reflects known patterns in how men and women engage with health services. They raised the possibility that men’s lower engagement, alongside the effects of mental illness itself, plays a part in their worse outcomes, while cautioning that the study cannot establish that link.

Where Type 2 Diabetes Care Falls Short

High blood pressure being the most common complication of diabetes is not surprising to clinicians. This study adds a clearer view of timing and sequence. Mental health conditions tended to emerge at the youngest median ages for both sexes in this data. For women, particularly younger women, a mental health diagnosis often came before heart or kidney problems even entered the picture. That ordering matters, because it points to a possible window of time, after a mental health diagnosis and before heart or kidney disease develops, when earlier action could potentially change what comes next.

Current UK medical guidelines, the researchers note, do not include sex-specific prevention or management strategies for diabetes and its complications, particularly regarding mental health. Incorporating routine mental health screening into diabetes care, especially for younger women, while strengthening early monitoring for heart and kidney disease among men, are among the practical directions the researchers point toward.

Both sexes who develop mental health conditions alongside diabetes fall into what the researchers describe as a high-risk group, one they argue is not always reached by care matched to that risk. For men especially, the combination of earlier death and lower healthcare use raises the question of whether some of the highest-risk patients are being caught early enough. Diabetes care as it stands tends to watch most closely for the complications everyone expects, rather than the sequences that prove most dangerous, and the researchers call for mental and physical health to be managed side by side.

Disclaimer: This article summarizes findings from a single observational study. Because the research was descriptive in design, it can identify patterns and associations but cannot prove that one condition causes another, including whether mental health conditions or lower healthcare use directly cause earlier death. Individual health outcomes vary, and findings drawn from UK health records may not apply equally to other countries or healthcare systems. This content is for informational purposes only and is not medical advice. Anyone with concerns about diabetes, depression, anxiety, or related conditions should consult a qualified healthcare professional.

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