Sex disparity in the management of dyslipidemia among patients with type 2 diabetes mellitus in a managed care organization.
OBJECTIVE
To determine whether there were sex-related differences in the management of dyslipidemia among managed care enrollees with diabetes mellitus.


METHODS
Retrospective analyses were conducted using medical and pharmacy claims data from a health maintenance organization during 2000 and 2001. Patients with type 2 diabetes mellitus were identified through a validated algorithm of medication and diagnosis codes. Chi-squared analysis was used to determine if women were less likely than men to receive a lipid test or a lipid-modifying drug. Logistic regression models were constructed to compare sex-related differences while controlling for age, cardiovascular disease diagnosis, and 2 proxies of illness severity (hospitalization in 2000 and the intensity of diabetes mellitus drug therapy).


RESULTS
During 2000 and 2001, 79.4% of women received a lipid test compared with 84.2% of men (chi2 = 6.69, P = .01). Also, 33.2% of women received a lipid-modifying drug compared with 45.5% of men (chi2 = 27.31, P < .01). Logistic regression analysis revealed that men were more likely than women to receive a lipid test when controlling for age, cardiovascular disease diagnosis, and illness severity (odds ratio [OR], 1.45; 95% confidence interval, 1.13-1.81). Men were also more likely than women to receive a lipid-modifying drug when controlling for age, cardiovascular disease diagnosis, illness severity, and lipid testing (OR, 1.51; 95% confidence interval, 1.22-1.86).


CONCLUSIONS
Women with type 2 diabetes mellitus were less likely than men with type 2 diabetes mellitus to receive lipid tests or lipid-modifying drugs.
Nau
David P
DP
Center for Medication Use, Policy and Economics, Department of Social and Administrative Sciences, University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109-1065, USA. dnau@umich.edu
Mallya
Usha
U
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control* / Q000628:therapy; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D008875:Middle Aged; D015146:Midwestern United States; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D016387:Women's Health