title: Earlier development of diabetic neuropathy in men than in women with type 2 diabetes mellitus.
abstract: BACKGROUND
  Data about the prevalence of diabetic neuropathy (DN) differ substantially, depending on the population and diagnostic methods. Sex-specific differences in DN are rarely discussed.
  
  
  OBJECTIVE
  The aims of the present study were to assess the prevalence of, and analyze sex differences in, DN in a hospital population with type 2 diabetes mellitus (T2DM) over a period of 18 years.
  
  
  METHODS
  In this retrospective study performed at a university hospital endocrinology clinic in Sofia, patient clinical records from 1990-2007 were examined. Patients were included in the database only at their first admission.
  
  
  RESULTS
  Data from 1705 patients with T2DM were analyzed (961 women, 744 men; mean [SD] age, 60.0 [11.9] years; diabetes duration, 9.9 [8.4] years; glycosylated hemoglobin, 9.0% [2.2%]; and body mass index, 29.4 [6.0] kg/m²). Obesity (46.3% vs 32.0%; P < 0.001), hypertension (86.7% vs 77.8%; P < 0.001), and dyslipidemia (61.2% vs 55.0%; P < 0.05) were significantly more common in women than in men, respectively. The prevalence of DN was 78.8%, with no significant sex differences. However, prevalence differed with time, corresponding to the frequency of application of electrophysiologic (electromyograms) or semiquantitative instrumental diagnostic methods. In men, the median (25th-75th percentiles) interval between diagnosis of T2DM and diagnosis of DN was 6 (1-12) years; in women, the interval was 8 (4-13) years (P < 0.01).
  
  
  CONCLUSIONS
  In this study of Bulgarian patients with T2DM, women were at higher macrovascular risk than were men. A high prevalence of DN was observed among these patients. The period from the diagnosis of T2DM to DN was shorter in men than in women-this necessitates earlier screening and therapeutic intervention for DN in men. Reasons for this sex difference may include differences in lifestyle and the testosterone deficiency that is common in men with diabetes, leading to a more pronounced deficit of neurosteroids.
authors.affiliation: Clinic of Endocrinology, Medical University-Sofia, Sofia, Bulgaria. zkamenov@hotmail.com
authors.forename: Zdravko Asenov
authors.initials: ZA
authors.lastname: Kamenov
authors.forename: Rumyana Atanasova
authors.initials: RA
authors.lastname: Parapunova
authors.forename: Rumyana Taneva
authors.initials: RT
authors.lastname: Georgieva
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002031:Bulgaria; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000209:etiology*; D050171:Dyslipidemias / Q000453:epidemiology; D004576:Electromyography; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000453:epidemiology / Q000209:etiology; D012737:Sex Factors; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human