Background
Methods
Study design and study population
Data collection
Definition of key variables
Statistical analysis
Results
Men | Women | p-value | |||
---|---|---|---|---|---|
(n = 624) | (n = 522) | ||||
Variables of interest | n | % | n | % | |
Age in years (mean, SD*)
| 67.2 (10.1) | 69.7 (10.5) | |||
Age in years
| |||||
≤59 |
137
|
22.0
|
84
|
16.1
| |
60 - 69 |
193
|
30.9
|
129
|
24.7
| |
70 - 79 |
239
|
38.3
|
231
|
44.3
| |
≥80 |
55
|
8.8
|
78
|
14.9
|
0.0001
|
Years of school education
| |||||
≤9 |
433
|
70.9
|
395
|
76.9
| |
10 - 12 |
104
|
17.0
|
94
|
18.2
| |
≥13 |
74
|
12.1
|
25
|
4.9
|
0.0001
|
Marital status
| |||||
Single/ widowed/ divorced |
112
|
18.1
|
209
|
40.2
| |
Married |
508
|
81.9
|
311
|
59.8
|
<0.0001
|
Occupational status
| |||||
Employed |
158
|
26.5
|
78
|
15.7
| |
Retired |
403
|
67.5
|
318
|
63.9
| |
Housewife |
0
|
0
|
80
|
16.1
| |
Other |
36
|
6.0
|
22
|
4.4
|
<0.0001
|
Smoking history
| |||||
Never |
174
|
28.0
|
375
|
72.0
| |
Ex-smoker |
355
|
57.2
|
100
|
19.2
| |
Current smoker |
92
|
14.8
|
46
|
8.8
|
<0.0001
|
Alcohol consumption
| |||||
Abstainer |
139
|
22.3
|
283
|
54.2
|
<0.0001
|
Body mass index (kg/m²)
| |||||
<25 | 76 | 12.2 | 78 | 14.9 | |
25 - <30 | 255 | 40.9 | 187 | 35.8 | |
30 - <35 | 194 | 31.1 | 161 | 30.8 | |
≥35 | 98 | 15.8 | 96 | 18.4 | 0.19 |
Glycemic control by HbA
1c
| |||||
Good (≤6.4%) | 241 | 38.6 | 213 | 41.1 | |
Moderate (6.5 - 7.4%) | 239 | 38.3 | 212 | 40.9 | |
Poor (≥7.5%) | 144 | 23.1 | 93 | 18.0 | 0.10 |
Mean HbA
1c
(SD) in % | 6.9 (1.1) | 6.8 (1.0) | 0.14 | ||
Mean HDL (SD) in mg/dl
| 47.7 (14.3) | 57.3 (17.2) |
<0.0001
| ||
Mean systolic BP (SD) in mmHg
| 137.8 (18.1) | 136.8 (19.0) | 0.41 | ||
Mean diastolic BP (SD) in mmHg
| 79.4 (10.2) | 79.6 (10.5) | 0.68 | ||
Physician reported time since diabetes diagnosis
| |||||
≤5 years | 241 | 38.6 | 213 | 40.8 | |
6 – 10 years | 185 | 29.7 | 146 | 28.0 | |
11 – 15 years | 104 | 16.7 | 81 | 15.5 | |
≥16 years | 94 | 15.1 | 82 | 15.7 | 0.82 |
Appointments with GPs (last 3 months)
| |||||
≤1 | 260 | 41.7 | 197 | 37.9 | |
2 – 3 | 245 | 39.3 | 216 | 41.5 | |
≥4 | 119 | 19.1 | 107 | 20.6 | 0.43 |
Participation in a DMP-DM
| 471 | 79.4 | 398 | 81.7 | 0.34 |
Medication adherence
| |||||
Good | 455 | 75.6 | 385 | 77.0 | |
Moderate | 132 | 21.9 | 102 | 20.4 | |
Poor | 15 | 2.5 | 13 | 2.6 | 0.83 |
General health status (self-rated)
| |||||
Excellent or very good | 62 | 10.0 | 40 | 7.7 | |
Good | 366 | 58.7 | 291 | 55.8 | |
Fair | 174 | 27.9 | 172 | 32.9 | |
Poor | 21 | 3.4 | 19 | 3.6 | 0.21 |
Physician diagnosed comorbidities
| |||||
Hypertension | 488 | 78.3 | 407 | 78.1 | 0.93 |
Hypercholesterolemia | 350 | 56.2 | 300 | 57.8 | 0.58 |
Coronary heart disease |
147
|
23.6
|
67
|
12.8
|
<0.0001
|
Heart failure | 75 | 12.0 | 64 | 12.3 | 0.89 |
Intermittent claudication |
96
|
15.4
|
36
|
6.9
|
<0.0001
|
Stroke |
47
|
7.5
|
22
|
4.2
|
0.02
|
Nephropathy |
76
|
12.2
|
45
|
8.6
|
0.05
|
Retinopathy | 51 | 8.2 | 35 | 6.7 | 0.35 |
Neuropathy | 144 | 23.1 | 104 | 20.0 | 0.20 |
Depression |
67
|
10.7
|
97
|
18.6
|
0.0002
|
Cancer | 63 | 10.1 | 49 | 9.4 | 0.70 |
Medication of interest | With coronary heart disease | Without coronary heart disease | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | Men | Women | |||||||
(n = 624) | (n = 522) | (n = 147) | (n = 67) | (n = 477) | (n = 455) | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Number of diabetes medication (mean, STD*)
| 1.3 (1.1) | 1.3 (1.2) | 1.5 (1.3) | 1.4 (1.1) | 1.3 (1.1) | 1.2 (1.2) | ||||||
Number of diabetes medication
| ||||||||||||
0 |
138
|
22.3
|
158
|
30.4
| 27 | 18.5 | 15 | 22.7 |
111
|
23.5
|
143
|
31.6
|
1 |
245
|
39.6
|
175
|
33.7
| 50 | 34.3 | 22 | 33.3 |
195
|
41.2
|
153
|
33.8
|
2 |
159
|
25.7
|
113
|
21.8
| 46 | 31.5 | 17 | 25.8 |
113
|
23.9
|
96
|
21.2
|
3 and more |
77
|
12.4
|
73
|
14.1
| 23 | 15.7 | 12 | 18.2 |
54
|
11.4
|
61
|
13.5
|
Biguanide
| 343 | 55.0 | 273 | 52.3 | 70 | 47.6 | 35 | 52.2 | 273 | 57.2 | 238 | 52.3 |
Sulfonylurea
| 132 | 21.2 | 92 | 17.6 | 32 | 21.8 | 14 | 20.9 | 100 | 21.0 | 78 | 17.1 |
Alpha-glucosidase inhibitor
| 14 | 2.2 | 13 | 2.5 | 5 | 3.4 | 1 | 1.5 | 9 | 1.9 | 12 | 2.6 |
Thiazolidinedione
|
39
|
6.3
|
19
|
3.6
| 11 | 7.5 | 3 | 4.5 | 28 | 5.9 | 16 | 3.5 |
Glinide
| 21 | 3.4 | 13 | 2.5 | 6 | 4.1 | 1 | 1.5 | 15 | 3.1 | 12 | 2.6 |
Glucagon-like peptide-I analogue (GLP-I) exenatide
| 6 | 1.0 | 5 | 1.0 | 4 | 2.7 | 0 | 0 | 2 | 0.4 | 5 | 1.1 |
Dipeptidyl peptidase-4 (DPP-4) inhibitor
| 20 | 3.2 | 28 | 5.4 | 7 | 3.3 | 4 | 6.0 | 17 | 3.6 | 24 | 5.3 |
Oral combination drug
|
26
|
4.2
|
9
|
1.7
| 6 | 4.1 | 1 | 1.5 |
20
|
4.2
|
8
|
1.8
|
Insulin treatment
| 123 | 19.8 | 107 | 20.5 | 43 | 29.7 | 20 | 29.8 | 80 | 16.8 | 87 | 19.1 |
Short acting insulin
| 47 | 7.5 | 40 | 7.7 | 16 | 10.9 | 7 | 10.4 | 31 | 6.5 | 33 | 7.3 |
Intermediate acting (basal insulin)
| 53 | 8.5 | 56 | 10.7 | 19 | 12.9 | 10 | 14.9 | 34 | 7.1 | 46 | 10.1 |
Human insulin combination (short and intermediate acting)
| 22 | 3.5 | 14 | 2.7 | 8 | 5.4 | 4 | 6.0 | 14 | 2.9 | 10 | 2.2 |
Insulin analogue
| 58 | 9.3 | 43 | 8.2 | 22 | 15.0 | 8 | 11.9 | 36 | 7.5 | 35 | 7.7 |
Medication of interest | All | With coronary heart disease | ||||||
---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | |||||
(n = 624) | (n = 522) | (n = 147) | (n = 67) | |||||
n | % | n | % | n | % | n | % | |
Antihypertensive drug
| 507 | 81.3 | 412 | 78.9 | 144 | 98.0 | 63 | 94.0 |
Angiotensin-converting enzyme (ACE) inhibitor |
431
|
69.1
|
316
|
60.5
|
120
|
81.6
|
45
|
67.2
|
Diuretic | 186 | 29.9 | 176 | 33.7 | 70 | 47.9 | 34 | 50.7 |
Beta-blocker | 267 | 42.8 | 228 | 43.7 | 112 | 76.2 | 48 | 71.6 |
Calcium channel blocker |
168
|
26.9
|
106
|
20.3
|
50
|
34.0
|
10
|
14.9
|
Lipid lowering drug
| 277 | 44.4 | 216 | 41.4 | 110 | 74.8 | 45 | 67.2 |
Aspirin
|
213
|
34.1
|
133
|
25.5
| 102 | 69.4 | 45 | 67.2 |
Total | With coronary heart disease | Without coronary heart disease | ||
---|---|---|---|---|
Diabetes Medication
| ||||
Thiazolidinedione
|
Crude
| 1.77 (1.01 - 3.09) | 1.73 (0.47 - 1.58) | 1.71 (0.91 - 3.21) |
Adjusted
a
| 1.75 (0.99 - 3.08) | 1.58 (0.41 - 6.07) | 1.68 (0.89 - 3.17) | |
Adjusted
b
| 1.42 (0.79 - 2.57)1 | 0.94 (0.28 - 3.17)2 | 1.52 (0.81 - 2.85)3 | |
Oral combination drug
|
Crude
| 2.48 (1.51 - 5.34) | 2.81 (0.33 - 23.79) | 2.45 (1.07 - 5.61) |
Adjusted
a
| 1.97 (0.94 - 4.13) | 1.82 (0.21 - 15.96) | 1.91 (0.82 - 4.45) | |
Adjusted
b
| 2.06 (0.98 - 4.31)4 | 1.93 (0.38 - 9.78)5 | 1.87 (0.84 - 4.13)6 | |
Coronary Heart Disease Medication
| ||||
Angiotensin-converting enzyme inhibitor
|
Crude
| 1.46 (1.14 – 1.86) | 2.17 (1.12 – 4.20) | |
Adjusted
a
| 1.52 (1.18 – 1.95) | 2.18 (1.09 – 4.35) | ||
Adjusted
c
| 1.44 (1.11 – 1.88)7 | - | ||
Adjusted
d
| - | 2.61 (1.26 – 5.42)8 | ||
Calcium channel blocker
|
Crude
| 1.45 (1.10 – 1.91) | 2.94 (1.38 – 6.24) | |
Adjusted
a
| 1.55 (1.17 – 2.06) | 3.53 (1.58 – 7.89) | ||
Adjusted
c
| 1.42 (1.05 – 1.91)9 | - | ||
Adjusted
d
| 3.64 (1.55 – 8.52)10 | |||
Aspirin
|
Crude
| 1.52 (1.17 – 1.96) | 1.10 (0.58 – 2.08) | |
Adjusted
a
| 1.80 (1.38 – 2.36) | 0.96 (0.49 – 1.87) | ||
Adjusted
e
| 1.36 (1.01 – 1.84)11 | - | ||
Adjusted
f
| - | 1.12 (0.57 – 2.21)12 |