The online version of this article (doi:10.1186/1475-2840-11-88) contains supplementary material, which is available to authorized users.
Heike U Krämer, Elke Raum contributed equally to this work.
The authors declare that they have no competing interests.
HUK conducted the statistical analysis and HUK and ER drafted the manuscript. ER, GR, DR, TR, JS and HB designed the study, supervised its implementation and field activities. All contributing authors were revising the manuscript critically for important intellectual content. All authors have read and approved the final version of the manuscript.
Coronary heart disease (CHD) is one of the most common long-term complications in people with type 2 diabetes. We analyzed whether or not gender differences exist in diabetes and CHD medication among people with type 2 diabetes.
The study was based on data from the baseline examination of the DIANA study, a prospective cohort study of 1,146 patients with type 2 diabetes conducted in South-West Germany. Information on diabetes and CHD medication was obtained from the physician questionnaires. Bivariate and multivariate analyses using logistic regression were employed in order to assess associations between gender and prescribed drug classes.
In total, 624 men and 522 women with type 2 diabetes with a mean age of 67.2 and 69.7 years, respectively, were included in this analysis. Compared to women, men had more angiopathic risk factors, including smoking, alcohol consumption and worse glycemic control, and had more often a diagnosed CHD. Bivariate analyses showed higher prescription of thiazolidinediones and oral combination drugs as well as of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers and aspirin in men than in women. After full adjustment, differences between men and women remained significant only for ACE inhibitors (OR = 1.44; 95%-confidence interval (CI): 1.11 – 1.88) and calcium channel blockers (OR = 1.42, 95%-CI: 1.05 – 1.91).
These findings contribute to current discussions on gender differences in diabetes care. Men with diabetes are significantly more likely to receive oral combination drugs, ACE inhibitors and calcium channel blockers in the presence of coronary heart disease, respectively. Our results suggest, that diabetic men might be more thoroughly treated compared to women. Further research is needed to focus on reasons for these differences mainly in treatment of cardiovascular diseases to improve quality of care.
Hayashi T, Kawashima S, Nomura H, Itoh H, Watanabe H, Ohrui T, Yokote K, Sone H, Hattori Y, Yoshizumi M, Ina K, Kubota K, the Japan Cholesterol and Diabetes Mellitus Investigation Group: Age, gender, insulin and blood glucose control status alter the risk of ischemic heart disease and stroke among elderly diabetic patients. Cardiovasc Diabetol. 2011, 10: 86-10.1186/1475-2840-10-86. PubMedCentralCrossRefPubMed
Mercuro G, Deidda M, Piras A, Dessalvi CC, Maffei S, Rosano GM: Gender determinants of cardiovascular risk factors and diseases. J Cardiovasc Med. 2010, 11: 207-220. CrossRef
American Diabetes Association (ADA): Standards of medical care in diabetes - 2010. Diabetes Care. 2010, 33 (Suppl 1): 11-61. CrossRef
Ferrara A, Mangione CM, Kim C, Marrero DG, Curb D, Stevens M, Selby JV: Translating Research Into Action for Diabetes Study Group. Sex disparities in control and treatment of modifiable cardiovascular disease risk factors among patients with diabetes: Translating Research Into Action for Diabetes (TRIAD) Study. Diabetes Care. 2008, 31: 69-74. 10.2337/dc08-1082. CrossRefPubMed
American Diabetes Association (ADA): Executive summary: standards of medical care in diabetes - 2010. Diabetes Care. 2010, 33 (Suppl 1): 4-10.
Schernthaner G, Forst T, Gulba D, Haberbosch W, Hanefeld M, Linss G, März W, Mehnert H, Rosak C, Schnell O, Seufert J, Tschöpe D, Erdmann E: Challenge in diabetes therapy: effects of glitazones beyond blood glucose control. Dtsch Med Wochenschr. 2009, 134: 949-954. 10.1055/s-0029-1220255. [Article in German] CrossRefPubMed
Gemeinsamer Bundesausschuss (GBA): Arzneimittel-Richtlinie/ Anlage III (Glitazone zur Behandlung des Diabetes mellitus Type 2). http://www.g-ba.de/informationen/beschluesse/1141/. 02 July 2012
European Medicines Agency: European Medicines Agency recommends suspension of Avandia, Avandamet and Avaglin. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/general/general_content_000420.jsp&mid=WC0b01ac058001d126. 02 July 2012
Hasslacher C, Wolf G, Kempe P, Ritz E: Diabetic Nephropathie. Diabetologie und Stoffwechsel. 2010, 5 (Suppl 2): S113-S116. [Article in German] CrossRef
Dallongville J, De Bacquer D, Heidrich J, De Backer G, Prugger C, Kotseva K, Montaye M, Amouyel P: Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event. Heart. 2010, 96: 1744-1749. 10.1136/hrt.2010.196170. CrossRef
Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, Armitage J, Baigent C, Cholesterol Treatment Trialists' (CTT) Collaborators: Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008, 371: 117-125. 10.1016/S0140-6736(08)60104-X. CrossRefPubMed
Squizzato A, Keller T, Romualdi E, Middeldorp S: Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease. Cochrane Database Syst Rev. 2011, CD005158.
Leosdottir M, Willenheimer R, Persson M, Nilsson PM: The association between glucometabolic disturbances, traditional cardiovascular risk factors and self-rated health by age and gender: a cross-sectional analysis within the Malmö preventive project. Cardiovasc Diabetol. 2011, 10: 118-10.1186/1475-2840-10-118. PubMedCentralCrossRefPubMed
Moebus S, Balijepalli C, Lösch C, Göres L, von Stritzky B, Bramlage P, Wasem J, Jöckel KH: Age- and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factors combinations of the metabolic syndrome –a cross-sectiona study. Cardiovasc Diabetol. 2010, 9: 34-10.1186/1475-2840-9-34. PubMedCentralCrossRefPubMed
- Gender disparities in diabetes and coronary heart disease medication among patients with type 2 diabetes: results from the DIANA study
Heike U Krämer
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II