SynthesisDiabetic medicine : a journal of the British Diabetic Association2026
Sex-specific differences in the prevalence of intermediate hyperglycaemia states: A systematic review and meta-analysis.
Synthesis in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
aimsTo evaluate the sex-specific prevalence of isolated impaired glucose tolerance, isolated impaired fasting glucose, combined impaired glucose tolerance and impaired fasting glucose and type 2 diabetes diagnosed by isolated glucose states.
methodsWe searched MEDLINE, Cochrane Database of Systematic Reviews, Embase and CINAHL from inception to 22.04.25. Title and abstract screening, full-text review, data extraction and risk of bias assessment (Hoy et al.) were conducted by two reviewers using pre-defined eligibility criteria. Sex-stratified prevalence and odds ratio for each intermediate hyperglycaemic state in women compared with men were pooled using a random-effects meta-analysis.
resultsWe identified 8 studies suitable for meta-analysis, including 52,256 participants (25,263 women). The pooled prevalences (95% CI) of isolated impaired glucose tolerance, isolated impaired fasting glucose (ADA thresholds) and combined impaired glucose tolerance in women were respectively 8% (7%,9%), 15% (12%,18%) and 7% (5%, 9%) and for men 5% (4%,7%), 21% (12%, 32%) and 7% (5%, 10%). Compared with men, women had higher odds of having isolated impaired glucose tolerance: 1.42 (1.23, 1.65), 0.65 (0.44, 0.96) lower odds of isolated impaired fasting glucose: 0.65 (0.44, 0.96) and similar odds of combined impaired glucose tolerance and impaired fasting glucose: 0.85 (0.46, 1.57). There was moderate certainty evidence for pooled prevalence estimates and high certainty evidence for comparisons of iIGT and iIFG between sexes.
conclusionsThere are sex-specific disparities in the prevalence of different isolated intermediate hyperglycaemic states, which may contribute to underdiagnosis and undertreatment in primary care and introduce ascertainment bias into research and policy.
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