In most regions of the world, type 1 diabetes is more common in girls than in boys. Since the 1970s, a female excess has been reported in populations of African and Asian origins. Indeed, most countries have reported either no gender difference or increased incidence of type 1 diabetes in girls. Contrary to these worldwide findings, certain endocrine centres in northern India report a higher outpatient attendance of men and boys with type 1 diabetes. Compared to girls, boys with diabetes are less likely to develop diabetic ketoacidosis, and appear to be more willing to follow intensive insulin therapy. The authors look at the factors behind this phenomenon, exposing some of the gender-related social and cultural issues that lead to the disproportionate burden of diabetes on young women in India. Accompanying their report, two frank testimonies illustrate some of the problems faced by women with the  condition in the region.