Sex-Specific differences in metabolic control, cardiovascular risk, and interventions in patients with type 2 diabetes mellitus

• Published in: Gender medicine 2010-12, Vol.7 (6), p.571-583
• Main Authors: Kautzky-Willer, Alexandra, MD, Kamyar, Majid Reza, PhD, Gerhat, Dora, MPharm, Handisurya, Ammon, MD, Stemer, Gunar, MPharm, Hudson, Stephen, PhD, Luger, Anton, MD, Lemmens-Gruber, Rosa, PhD
• Format: Article
• Language: English
• Subjects: Aged; Angina Pectoris - prevention & control; Angioplasty, Balloon, Coronary; Antihypertensive Agents - therapeutic use; Aspirin - therapeutic use; Biological and medical sciences; Blood Glucose - metabolism; blood pressure; Blood Pressure - physiology; Brain Ischemia - complications; Brain Ischemia - epidemiology; cardiovascular risk; Coronary Artery Bypass; Coronary Disease - complications; Coronary Disease - metabolism; Coronary Disease - physiopathology; Coronary Disease - surgery; Coronary Disease - therapy; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - metabolism; Diabetic Angiopathies - physiopathology; Diabetic Angiopathies - therapy; diabetic complications; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; gender; Glycated Hemoglobin A - metabolism; Humans; Hypoglycemic Agents - therapeutic use; Internal Medicine; lipid profile; Lipids - blood; Male; Medical sciences; Metabolic Syndrome - complications; Metabolic Syndrome - metabolism; Metabolic Syndrome - physiopathology; Middle Aged; Miscellaneous; Myocardial Infarction - prevention & control; Patient Compliance; Primary Prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; Secondary Prevention; Sex Factors; type 2 diabetes mellitus
• ISSN: 1550-8579; 1878-7398
• DOI: 10.1016/j.genm.2010.12.001

Abstract Background: Sex-specific differences appear particularly relevant in the management of type 2 diabetes mellitus (T2DM), with women experiencing greater increases in cardiovascular morbidity and mortality than do men. Objective: The aim of this article was to investigate the influence of biological sex on clinical care and microvascular and macrovascular complications in patients with T2DM in a Central European university diabetes clinic. Methods: In a cross-sectional study, sex-specific disparities in metabolic control, cardiovascular risk factors, and diabetic complications, as well as concomitant medication use and adherence to treatment recommendations, were evaluated in 350 consecutive patients who were comparable for age, diabetes duration, and body mass index. Study inclusion criteria included age ≤75 years, T2DM, a documented history of presence or absence of coronary heart disease (CHD), and informed consent. Patients were followed in the diabetes outpatient clinic between November 2007 and March 2008. Results: Two hundred and one patients with T2DM met inclusion criteria (93 [46.3%] women, 108 [53.7%] men). Women with T2DM had higher mean (SE) systolic blood pressure (155.4 [22.5] vs 141.0 [19.8] mm Hg for men; P < 0.001) and total cholesterol (TC) (5.28 [1.34] vs 4.86 [1.29] mmol/L for men; P < 0.05), but a lower TC:HDL-C ratio (4.1 [1.19] vs 4.5 [1.2] for men; P < 0.05). Slightly more men (32.4%) than women (26.9%) reached the therapeutic goal of