title: Sex disparities in diabetes process of care measures and self-care in high-risk patients.
abstract: Patients with chronic diabetic complications experience high morbidity and mortality. Sex disparities in modifiable factors such as processes of care or self-care activities have not been explored in detail, particularly in these high-risk patients. Sex differences in processes of care and self-care activities were assessed in a cross-sectional analysis of the Pathways Study, an observational cohort of primary care diabetic patients from a managed care organization (N = 4,839). Compared to men, women had decreased odds of dyslipidemia screening (adjusted odds ratio (AOR) 0.73, 95% CI 0.62-0.85), reaching low-density lipoprotein goal (AOR 0.70, 95% CI 0.58-0.86), and statin use (AOR 0.69, 95% CI 0.58-0.81); women had 19% greater odds of reaching hemoglobin A1c <7% (95% CI 1.02-1.41). There were no sex differences in hemoglobin A1c testing, microalbuminuria screening, or angiotensin-converting enzyme inhibitor use. Women were less likely to report regular exercise but had better adherence to healthy diet, glucose monitoring, and self-foot examination compared to men. Patterns of sex differences were consistent in subjects with diabetic complications. Significant sex disparities exist in diabetes process of care measures and self-care, even amongst patients known to have chronic diabetic complications.
authors.affiliation: Division of Nephrology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA ; Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA ; Kidney Research Institute, 325 9th Avenue, P. O. Box 359606, Seattle, WA 98104, USA.
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Yu
authors.forename: Courtney Rees
authors.initials: CR
authors.lastname: Lyles
authors.forename: Luis A
authors.initials: LA
authors.lastname: Bent-Shaw
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young