A new model diversifies diagnostic and therapeutic pathways for men and women affected by endo-diabetological conditions: "Money is saved and more patients are treated".
While the government and regional authorities continue to argue over the ministerial decree aimed at reducing waiting lists for medical visits and tests, solutions to the problem are being studied elsewhere. A proposal comes from Professor Livio Luzi, full professor of endocrinology at the Università Statale di Milano and director of the inter-facility department of endocrinology, nutrition and metabolic diseases at MultiMedica, the private group within which he has begun to structure, together with a multidisciplinary team, one of the first examples in Lombardy of a ward dedicated exclusively to women's health, both physical and psychological: "Money is saved and more patients are treated", he argues.
The topic was discussed in Milan at the congress "Endo-diabe 2025: gender medicine for the endocrinologist", organised by Irccs MultiMedica and the Università Statale di Milano. Experts took stock of the latest developments regarding biological and hormonal differences between males and females in how diseases manifest and how they respond to treatment, focusing on endocrinology and diabetology, two disciplines strongly influenced by gender-related factors.
"In a simulation we submitted to the relevant institutions, we hypothesised reorganising the endocrinology operating unit of a Lombardy hospital by introducing gender-specific diagnostic, therapeutic and care pathways for three conditions: osteoporosis, thyroid nodules and prolactinomas, all of which are more prevalent in the female gender", continues Luzi, who is also a member of the Technical Committee on Gender Medicine of Regione Lombardia. "Against some initial costs due to staff training, the acquisition of new technology and the effort to make laboratory tests more precise, we calculated several advantages. The male Pdta for osteoporosis, for example, by reducing the need for Moc (computerised bone densitometry) and X-rays, would allow the facility to increase the number of manageable patients by 30 per cent; the female one for thyroid nodules would make it possible to reduce thyroidectomies, and the one for prolactinomas to halve the number of pituitary MRI scans."
Taken together, it is estimated that the six personalised pathways could cut the costs of the operating unit by 16.9 per cent borne by the regional health service, while at the same time treating more patients and helping to reduce waiting lists.
A factor not to be underestimated even for Health Minister Orazio Schillaci, who in March had sent a letter to the regions expressing concern about the "too many unacceptable situations" and "opaque practices" hindering access to care. One of the most well-known (which has proved to be irregular) is the closure of appointment books — that is, the impossibility of booking because there are no slots available, not even months in advance.
And then there is diabetes: in Italy its prevalence is growing, as are the complications associated with it, such as diabetic retinopathy. "The male sex is an independent risk factor for this condition in its advanced stage, and numerous studies show that the disease, of any degree, is significantly more frequent in men", comments Stela Vujosevic, director of the Complex Operative Unit of Ophthalmology – Medical Retina at Ospedale San Giuseppe, and associate professor at the Department of Biomedical, Surgical and Dental Sciences of the Università degli Studi di Milano.
All considerations that highlight the importance of a gender-specific approach in this clinical field as well, in both private and public healthcare.