Sex differences in cardiometabolic risk factors, pharmacological treatment and risk factor control in type 2 diabetes: findings from the Dutch Diabetes Pearl cohort

Diabet Pearl Parelsnoer Initiative, Marit de Jong, Marieke J. Oskam, Simone J. S. Sep, Behiye Ozcan, Femke Rutters, Eric J. G. Sijbrands, Petra J. M. Elders, Sarah E. Siegelaar, J. Hans DeVries, Cees J. Tack, Marielle Schroijen, Harold W. de Valk, Evertine J. Abbink, Coen D. A. Stehouwer, Ingrid Jazet, Bruce H. R. Wolffenbuttel*, Sanne A. E. Peters, Miranda T. Schram

*Corresponding author for this work

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Abstract

Introduction Sex differences in cardiometabolic risk factors and their management in type 2 diabetes (T2D) have not been fully identified. Therefore, we aimed to examine differences in cardiometabolic risk factor levels, pharmacological treatment and achievement of risk factor control between women and men with T2D.

Research design and methods Cross-sectional data from the Dutch Diabetes Pearl cohort were used (n=6637, 40% women). Linear and Poisson regression analyses were used to examine sex differences in cardiometabolic risk factor levels, treatment, and control.

Results Compared with men, women had a significantly higher body mass index (BMI) (mean difference 1.79 kg/m(2) (95% CI 1.49 to 2.08)), while no differences were found in hemoglobin A(1c) (HbA(1c)) and systolic blood pressure (SBP). Women had lower diastolic blood pressure (-1.94 mm Hg (95% CI -2.44 to -1.43)), higher total cholesterol (TC) (0.44 mmol/L (95% CI 0.38 to 0.51)), low-density lipoprotein cholesterol (LDL-c) (0.26 mmol/L (95% CI 0.22 to 0.31)), and high-density lipoprotein cholesterol (HDL-c) sex-standardized (0.02 mmol/L (95% CI 0.00 to 0.04)), and lower TC:HDL ratio (-0.29 (95% CI -0.36 to -0.23)) and triglycerides (geometric mean ratio 0.91 (95% CI 0.85 to 0.98)). Women had a 16% higher probability of being treated with antihypertensive medication in the presence of high cardiovascular disease (CVD) risk and elevated SBP than men (relative risk 0.84 (95% CI 0.73 to 0.98)), whereas no sex differences were found for glucose-lowering medication and lipid-modifying medication. Among those treated, women were less likely to achieve treatment targets of HbA(1c)(0.92 (95% CI 0.87 to 0.98)) and LDL-c (0.89 (95% CI 0.85 to 0.92)) than men, while no differences for SBP were found.

Conclusions In this Dutch T2D population, women had a slightly different cardiometabolic risk profile compared with men and a substantially higher BMI. Women had a higher probability of being treated with antihypertensive medication in the presence of high CVD risk and elevated SBP than men, and were less likely than men to achieve treatment targets for HbA(1c) and LDL levels.

Original languageEnglish
Article number001365
Number of pages9
JournalBMJ Open Diabetes Research & Care
Volume8
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • diabetes mellitus
  • type 2
  • epidemiology
  • healthcare disparities
  • CORONARY-HEART-DISEASE
  • CARDIOVASCULAR-DISEASE
  • WOMEN
  • MEN
  • DISPARITIES
  • METAANALYSIS
  • COMPLICATIONS
  • INDIVIDUALS
  • MORTALITY
  • MELLITUS

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