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Diabetes Treatment and Management · Journal article
Journal of Women S Health · August 13, 2026
Well-designed and adequately powered for the question it asks.
This large cross-sectional registry study of over 570,000 people with type 2 diabetes in Italy documents clinically meaningful sex disparities in access to guideline-recommended cardioprotective therapies (SGLT2 inhibitors and GLP-1 receptor agonists), monitoring (albuminuria, retinopathy), and markers of clinical inertia, despite similar overall quality-of-care scores and despite women bearing comparable or higher cardiometabolic risk. The findings suggest systematic undertreatment of women with T2D and argue for gender-sensitive care protocols.
Cross-sectional registry analysis. Adults with active type 2 diabetes attending participating Italian diabetes clinics; enrolled if they had ≥1 antidiabetic prescription and ≥1 clinical assessment during 2023.. Compared with: Sex comparison (women vs. men). n = 571,962. 296 diabetes clinics in Italy (AMD Annals Initiative).
Study included 571,962 individuals with T2D; 41.5% were women Women exhibited higher BMI, greater prevalence of severe obesity, and poorer lipid control than men Women were significantly less likely to receive SGLT2 inhibitors and GLP-1 receptor agonists, particularly with concurrent chronic kidney disease, cardiovascular disease, or heart failure
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should recognize that women with T2D face documented disparities in access to evidence-based cardioprotective medications and monitoring for microvascular complications, even when baseline risk is comparable or higher. Implementation of gender-aware treatment protocols and audit of prescribing patterns may help reduce these inequities.
Large real-world registry analysis of >570,000 patients with robust stratification by sex, identifying consistent disparities in cardioprotective therapy access and monitoring—rigorous design with clear actionable findings on a clinically important outcome, though observational.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that women with T2D face documented disparities in access to evidence-based cardioprotective medications and monitoring for microvascular complications, even when baseline risk is comparable or higher. Implementation of gender-aware treatment protocols and audit of prescribing patterns may help reduce these inequities.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
BACKGROUND: Sex and gender differences substantially influence the epidemiology, clinical presentation, and outcomes of type 2 diabetes (T2D). Although guideline-recommended cardiometabolic therapies have expanded in recent years, evidence suggests that women with T2D continue to experience disparities in risk factor control, access to cardioprotective treatments, and clinical outcomes. This study aimed to evaluate sex-based differences in quality of care, treatment patterns, and clinical inertia using real-world data from the Associazione Medici Diabetologi (AMD) Annals Initiative. METHODS: We conducted a cross-sectional analysis of 2023 data from 296 diabetes clinics participating in the AMD Annals registry. Adults with active T2D (≥1 antidiabetic prescription and ≥1 clinical assessment in 2023) were included. Process indicators, intermediate outcomes, pharmacologic treatments, and final outcomes were assessed according to AMD Indicators (Revision 9). All analyses were stratified by sex. RESULTS: The study included 571,962 individuals with T2D (41.5% women). Glycemic control and overall quality-of-care scores were similar between sexes. However, women exhibited higher BMI, greater prevalence of severe obesity, poorer lipid control, and higher rates of reduced eGFR. Despite comparable or higher cardiometabolic risk, women were less frequently monitored for albuminuria and retinopathy and were significantly less likely to receive SGLT2 inhibitors and GLP-1 receptor agonists, particularly in the presence of chronic kidney disease, cardiovascular disease, or heart failure. Indicators of clinical inertia consistently disadvantaged women, especially regarding cardioprotective therapies. CONCLUSIONS: Despite comparable overall quality-of-care scores, clinically meaningful sex disparities persist in T2D management in Italy. Women experience a higher burden of metabolic risk and reduced access to evidence-based cardioprotective treatments. These findings highlight the urgent need for gender-sensitive diabetes care strategies to reduce therapeutic inequities and improve cardiovascular and renal outcomes in women with T2D.
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