T2D: sex differences identified in management of CVD risk

  • Wright AK & al.
  • Circulation
  • 15 Apr 2019

  • International Clinical Digest
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Takeaway

  • No significant sex disparities are present in cardiovascular disease (CVD) risk associated with incident type 2 diabetes (T2D), but some risk factor management elements differ.   
  • Findings highlight need for closer adherence to prescribing guidance and attention paid to sex bias.

Why this matters

  • CVD is the leading cause of death in people with diabetes.

Study design

  • Retrospective cohort study using the UK Clinical Practice Research Datalink, of 79,985 people with incident T2D between 2006 and 2013, matched to 386,547 without diabetes (44.3% and 44.8% women, respectively).
  • Funding: Diabetes UK.

Key results

  • During 3.6 years of follow-up, major adverse cardiac events (MACE) occurred in 12.3% with diabetes, 7.8% without.
  • After adjustment for modifiable and nonmodifiable baseline factors, estimated HR (95% CI) for incident T2D-associated MACE:
    • 1.23 (1.16-1.32) for women and
    • 1.17 (1.11-1.23) for men; 
    • Nonsignificant excess risk in women (relative risk ratio, 1.05 [0.97-1.14]).
  • Women had better glycemic control than men and were more likely to be obese and have hypertensive end-organ damage and hypercholesterolemia.
  • Statin prescribing was lower in women (65.2% vs 69.1% in year 1) despite more frequent health care contacts.

Limitations

  • Missing data.  
  • Only incident, not prevalent, T2D included.
  • Relatively short follow-up.
  • All-UK population.

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