Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC

M E Larkin; J-Y Backlund; P Cleary; M Bayless; B Schaefer; J Canady; D M Nathan; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group

doi:10.1111/j.1464-5491.2010.02972.x

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Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC

Journal article

Peer reviewed

Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC

M E Larkin, J-Y Backlund, P Cleary, M Bayless, B Schaefer, J Canady, D M Nathan and Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group

Diabetic medicine, Vol.27(4), pp.451-458

04/2010

DOI: 10.1111/j.1464-5491.2010.02972.x

PMID: 20536518

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Abstract

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. 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. 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). 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.

Blood Pressure

Cross-Sectional Studies

Diabetes Mellitus, Type 1 - physiopathology

Glycated Hemoglobin A - metabolism

Humans

Middle Aged

Risk Factors

Antihypertensive Agents - administration & dosage

Male

Diabetes Mellitus, Type 1 - complications

Diabetes Mellitus, Type 1 - therapy

Gender Identity

Lipids - blood

Coronary Disease - therapy

Sex Factors

Healthcare Disparities

Adult

Cholesterol, LDL - blood

Female

Disease Management

Cohort Studies

Details

Title: Subtitle: Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC
Creators: M E Larkin - Massachusetts General Hospital Diabetes Center, Boston, MA 02114, USA. mlarkin1@partners.org
J-Y Backlund
P Cleary
M Bayless
B Schaefer
J Canady
D M Nathan
Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group
Resource Type: Journal article
Publication Details: Diabetic medicine, Vol.27(4), pp.451-458
Publisher: England
DOI: 10.1111/j.1464-5491.2010.02972.x
PMID: 20536518
ISSN: 0742-3071
eISSN: 1464-5491
Language: English
Date published: 04/2010
Academic Unit: Otolaryngology; Ophthalmology and Visual Sciences
Record Identifier: 9983979931902771

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