Persistent sex differences in diabetes management (1997–2022): 25 years of national evidence from the Swiss Health Survey

Objective

To evaluate sex-specific trends in diabetes management in Switzerland over a 25-year period using nationally representative data, and to determine whether menopausal status modifies these differences.

Methods

We analyzed six Swiss Health Surveys (1997–2022) to assess sex differences in diabetes screening, diagnosis, treatment, and control. Multivariable logistic regressions were adjusted for demographic, socioeconomic, and lifestyle covariates. Age-stratified analyses explored life-stage-specific patterns, using age > 50 as a proxy for menopausal status.

Results

A total of 80,133 participants (54.5 % female) were included. After multivariable adjustment, females showed a higher likelihood of recent diabetes screening than males across all survey years (e.g., OR 1.20, 95 % CI 1.12–1.28 in 2022), with no evidence of narrowing over time. Conversely, females had a consistently lower likelihood of being diagnosed with diabetes (e.g., OR 0.71, 95 % CI 0.63–0.81 in 2022) and of being treated once diagnosed (e.g., OR 0.56, 95 % CI 0.40–0.80 in 2022), with no temporal improvement. No significant sex differences in diabetes control were observed among those treated. Age-stratified analyses revealed that sex disparities varied by age, potentially reflecting that life-stage-related factors may contribute to the observed disparities.

Conclusions

This study highlights persistent, age-modulated sex differences in diabetes management over two decades in Switzerland. While diabetes control was similar between sexes once treatment was initiated, inequities in screening, diagnosis, and treatment remain.