Sex disparities in medication prescribing amongst patients with type 2 diabetes mellitus managed in primary care

Martina Ambrož, Marit Geelink, Kirsten P.J. Smits, Sieta T. de Vries, Petra Denig*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Sex differences in clinical outcomes have been observed for patients with type 2 diabetes mellitus (T2DM). These could be related to sex disparities in treatment.

Objectives: To determine whether there are sex disparities in medication prescribing amongst patients with T2DM.

Methods: A cohort study was conducted using the Groningen Initiative to ANalyze Type 2 diabetes Treatment (GIANTT) database, which includes data from primary care patients with T2DM from the north of the Netherlands. Data on demographics, physical examinations, laboratory measurements and prescribing were extracted. A set of validated prescribing quality indicators assessing the prevalence, start, intensification and safety of glucose-, lipid-, blood pressure- and albuminuria-lowering medication was applied for the calendar year 2019. Univariate logistic regression analyses were conducted.

Results: We included 10,456 patients (47% females). Females were less often treated with metformin (81.7% vs. 86.5%; OR 0.70, 95% CI 0.61–0.80), and were less often prescribed a renin-angiotensin-aldosterone inhibitor (RAAS-i) when treated with multiple blood pressure-lowering medicines (81.9% vs. 89.3%; OR 0.55, 95% CI 0.46–0.64) or when having albuminuria (74.7% vs. 82.1%; OR 0.64, 95% CI 0.49–0.85) than males. Statin treatment was less frequently started (19.7% vs. 24.7%; OR 0.75, 95% CI 0.58–0.96) and prescribed (58.7% vs. 63.9%; OR 0.80, 95% CI 0.73–0.89) in females. There were no differences in starting and intensifying glucose-, blood pressure- and albuminuria-lowering medication.

Conclusions: Sex disparities in medication prescribing amongst T2DM patients were seen, including less starting with statins and potential undertreatment with RAAS-i in females. Such disparities may partly explain higher excess risks for cardiovascular and renal complications associated with diabetes observed in females.

Original languageEnglish
Article numbere14987
Number of pages10
JournalDiabetic Medicine
Issue number1
Early online date24-Oct-2022
Publication statusPublished - Jan-2023


  • medication treatment
  • prescribing quality indicators
  • quality of care
  • sex disparities
  • type 2 diabetes mellitus

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