alexa Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT EDIC.
Diabetes & Endocrinology

Diabetes & Endocrinology

Journal of Diabetes & Metabolism

Author(s): Larkin ME, Backlund JY, Cleary P, Bayless M, Schaefer B,

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Abstract AIMS: Coronary heart disease (CHD) is a major cause of morbidity and mortality in patients with diabetes. Sex disparity in the treatment of modifiable CHD risk factors in patients with Type 2 diabetes has been reported previously; however, there is little comparable information in Type 1 diabetes. METHODS: We performed a cross-sectional analysis of 1153 subjects with Type 1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort to compare achievement of metabolic and CHD risk factor goals and use of recommended risk factor interventions between the sexes. RESULTS: Women were less likely than men to achieve glycated haemoglobin (HbA1c)<7.0\% [adjusted odds ratio (AOR) 0.76, 95\% confidence interval (CI) 0.57-0.995] or<8.0\% (AOR 0.74, 95\% CI 0.58-0.95). Achievement of target lipid levels was not significantly different between the sexes. As in the non-diabetic population, men had higher blood pressure. Women were significantly less likely than men to report using aspirin (AOR 0.77, 0.60-0.99) and angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (AOR 0.62, 0.49-0.80) and statins (AOR 0.56, 0.43-0.73), even after adjusting for blood pressure and lipid levels, respectively. Reported use of statins was also lower in women than men in the subset that developed a low-density lipoprotein (LDL) cholesterol level>3.4 mmol/l (39\% vs. 60\%, P<0.05). CONCLUSIONS: In Type 1 diabetes, women report lower frequency than men in the use of interventions that decrease CHD risk. These findings are consistent with reports in the Type 2 diabetic population, showing that risk-reducing measures are underused in women with diabetes. TRIAL REGISTRATION: ClinicalTrials.gov NCT00360815 NCT00360893. This article was published in Diabet Med and referenced in Journal of Diabetes & Metabolism

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