Structured personal diabetes care in primary health care affects only women's HbA1c.
OBJECTIVE
Diabetic men and women differ in lifestyle and attitudes toward diabetes and may benefit differently from interventions to improve glycemic control. We explored the relation between HbA1c (A1C), sex, treatment allocation, and their interactions with behavioral and attitudinal characteristics in patients with type 2 diabetes.


METHODS
Six years after their diabetes diagnosis, a population-based sample of 874 primary care patients cluster-randomized to receive structured personal care or routine care reported lifestyle, medication, social support, diabetes-related consultations, and attitudes toward diabetes. Multivariate analyses were applied, split by sex.


RESULTS
A marked intervention effect on A1C was confined to the structured personal care women. The median A1C was 8.4% in structured personal care women and 9.2% in routine care women (P < 0.0001) and 8.5% in structured personal care men and 8.9% in routine care men (P = 0.052). Routine care women had a 1.10 times higher A1C than structured personal care women, (P < 0.0001, adjusted analysis). Structured personal care women had relatively more consultations than routine care women, but neither number of consultations nor other covariates helped to explain the sex difference in A1C. Irrespective of treatment allocation, women had more adaptive attitudes toward diabetes but lacked support compared with men.


CONCLUSIONS
In this study, the observed effect of structured personal care on A1C was present only among women, possibly because they were more inclined to comply with regular follow-up and had a tendency to have a more adaptive attitude toward diabetes.
Nielsen
Anni B S
AB
The Research Unit for General Practice in Copenhagen, Oster Farimagsgade 5, P.O. Box 2099, DK-1014, Copenhagen K, Denmark. a.nielsen@gpract.ku.dk
de Fine Olivarius
Niels
N
Gannik
Dorte
D
Hindsberger
Charlotte
C
Hollnagel
Hanne
H
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000401:mortality / Q000534:rehabilitation*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010548:Personal Health Services; D012727:Sex Characteristics; D016019:Survival Analysis; D016387:Women's Health
D001786:Blood Glucose; D006442:Glycated Hemoglobin