title: Gender differences in diabetes mellitus and effects on self-care activity.
abstract: BACKGROUND
  Effective self-care, including adherence to diet, exercise, and medication regimens, is an essential component of health care for individuals with diabetes mellitus (DM).
  
  
  OBJECTIVE
  The goals of this study were to examine sex-based differences in DM and to explore the effects of gender on self-care.
  
  
  METHODS
  This study was conducted retrospectively using data from the 2001 Medical Expenditure Panel Survey (MEPS). People with DM were identified by International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code; analyses were stratified by sex. Variables included age, race/ethnicity, education, income, body mass index (BMI), number of comorbidities, physical and cognitive limitations, smoking status, and depression. Outcome measures were assessed by Short Form-12 (SF-12) Mental Component Summary (MCS) and Physical Component Summary (PCS) scores. Univariate analyses were determined using t, chi(2), or Fisher exact tests, as appropriate. Multivariate analyses examined associations between sex and SF-12 MCS/PCS scores adjusted for other variables.
  
  
  RESULTS
  A total of 1653 MEPS respondents (883 women, 770 men) with DM were identified for the current study. The women were significantly older than the men (61.2 vs 59.1 years), had less education (11.1 vs 12.0 years), and had lower incomes. Women had higher calculated BMI (31.4 vs 30.3), more comorbidities (7.8 vs 6.4), more depression, and more physical and cognitive limitations than did men. Women also scored lower than men on the SF-12 MCS and PCS (47.8 vs 49.9 and 38.2 vs 41.4, respectively). All these measures were statistically significant (P < 0.01). In multivariate analyses, physical limitations, BMI, and number of comorbidities were negatively correlated, and income and education were positively correlated, with MCS and PCS scores.
  
  
  CONCLUSIONS
  Compared with their male counterparts, diabetic women scored lower on measures of health status and functioning-factors that are likely to affect self-care activities. Sex-based differences should be considered when developing screening and treatment programs for people with DM.
authors.affiliation: University of Colorado at Denver and Health Sciences Center, School of Pharmacy, Denver, Colorado 80262, USA. Marianne.McCollum@uchsc.edu
authors.forename: Marianne
authors.initials: M
authors.lastname: McCollum
authors.forename: Laura S
authors.initials: LS
authors.lastname: Hansen
authors.forename: Lisa
authors.initials: L
authors.lastname: Lu
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Sullivan
mesh_terms: D000203:Activities of Daily Living; D015992:Body Mass Index; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012648:Self Care; D012737:Sex Factors