The prevalence of type 2 diabetes is increasing in both sexes, with men usually being diagnosed at a younger age and with a lower body fat mass. Women often have a higher risk factor profile at diagnosis, particularly in relation to obesity and psychosocial stress. Pregnancy and menopause also increase the cardiometabolic risk in women. Women have a higher relative risk of cardiovascular disease and mortality compared to men. Gender-specific prevention strategies are still under development and require a better understanding of differences and mechanisms. Differing health effects of diabetes in men and women require personalized prevention and treatment strategies for optimal care.