Gender differences in cardiovascular disease risk factors, treatments and complications in patients with type 2 diabetes: the RIACE Italian multicentre study

• DOI: 10.1111/joim.12073
• Publication Date: 2013-04-12T14:03:48Z
• Authors: G. Penno; A. Solini; E. Bonora; C. Fondelli; E. Orsi; G. Zerbini; R. Trevisan; M. Vedovato; G. Gruden; L. Laviola; A. Nicolucci; G. Pugliese
• Keywords: Male; Prognosi; Hypercholesterolemia; Cardiovascular disease risk factors; Complications; Gender; Treatment disparities; Type 2 diabetes;; Sex Factor; Severity of Illness Index; Type 2 diabete; Body Mass Index; cardiovascular disease risk factors; complications; gender; treatment disparities; type 2 diabetes; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; 5. Gender equality; Cardiovascular disease risk factors; Complications; Gender; Treatment disparities; Type 2 diabetes; Aged; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; Hypercholesterolemia; Hyperglycemia; Hypertension; Italy; Male; Middle Aged; Prognosis; Risk Factors; Severity of Illness Index; Sex Factors; Survival Analysis; Treatment Outcome; Internal Medicine; Risk Factors; Cardiovascular Disease; Diabetes Mellitus; Internal Medicine; Humans; 10. No inequality; Aged; Cross-Sectional Studie; Cardiovascular disease risk factors; Complications; Gender; Treatment disparities; Type 2 diabetes; Treatment disparitie; Risk Factor; Gender; Type 2 diabetes; Middle Aged; Prognosis; Survival Analysis; 3. Good health; Cross-Sectional Studies; Treatment Outcome; Diabetes Mellitus, Type 2; Italy; Cardiovascular Diseases; Hyperglycemia; Hypertension; Female; Survival Analysi; Cardiovascular disease risk factor; Complication; complications; cardiovascular disease risk factors; gender; treatment disparities; type 2 diabetes; Type 2; Human

AbstractObjectivesPoorer control of risk factors for cardiovascular disease (CVD) has been reported in diabetic women, as compared with diabetic men. It has been proposed that this finding is due to gender disparities in treatment intensity. We investigated this hypothesis in a large contemporary cohort of subjects with type 2 diabetes.DesignObservational, cross‐sectional study.Subjects and settingConsecutive patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian multicentre study (n = 15 773), attending 19 hospital‐based diabetes clinics in 2007–2008.Main outcome measuresTraditional CVD risk factors, macro‐ and microvascular complications and current glucose‐, lipid‐ and blood pressure (BP)‐lowering treatments were assessed.ResultsAlthough CVD was more prevalent in men, women showed a less favourable CVD risk profile and worse performance in achieving treatment targets for haemoglobin A1c, LDL, HDL and non‐HDL cholesterol, systolic blood pressure (BP) and in particular obesity [body mass index (BMI) and waist circumference], but not for triglycerides and diastolic BP. However, women were more frequently receiving pharmacological treatment for hypertension and to a lesser extent hyperglycaemia and dyslipidaemia than men, and female gender remained an independent predictor of unmet therapeutic targets after adjustment for confounders such as treatments, BMI, duration of diabetes and, except for the systolic BP goal, age.ConclusionsIn women with type 2 diabetes from the RIACE cohort, a more adverse CVD risk profile and a higher likelihood of failing treatment targets, compared with men, were not associated with treatment differences. This suggests that factors other than gender disparities in treatment intensity are responsible.