Gender differences in cardiovascular risk factors in incident diabetes.
BACKGROUND
Cardiovascular disease is a major cause of morbidity and mortality for women and men with diabetes. Previous cross-sectional studies of prevalent diabetes have found that women are less likely to meet American Diabetes Association (ADA) and American Heart Association guidelines for control of cardiovascular risk factors (hemoglobin A1c, low-density lipoprotein [LDL] cholesterol, and blood pressure), but have not studied the critical period immediately after diagnosis.


METHODS
To assess gender differences in cardiovascular risk factors at the time of diabetes diagnosis (baseline) and 1 year later (follow-up), we conducted a retrospective cohort study of 6,547 individuals with incident diabetes in an integrated care delivery system. We assessed mean cardiovascular risk factor values by gender and adjusted odds ratios of attaining ADA goals.


RESULTS
Compared with men, at baseline women had lower hemoglobin A1c (7.9% vs. 8.2%; p < .001), higher LDL cholesterol (118.9 vs. 111.5 mg/dL; p < .001), higher systolic blood pressure (131.9 vs. 130.5 mmHg; p < .001), and lower diastolic blood pressure (79.1 vs. 79.7 mmHg; p = .006). At follow-up, the hemoglobin A1c gender gap had closed (6.9% vs. 6.9%; p = .39), and the gender gaps had decreased for blood pressure (129.8/77.0 vs. 128.9/77.6; p = .009) and LDL cholesterol (104.0 vs. 98.2 mg/dL; p < .001). These associations varied by age. Adjusted odds ratios showed similar relationships.


CONCLUSIONS
In this cohort of individuals with incident diabetes, men and women had important differences in risk factor control at the time of diabetes diagnosis. These differences varied by age and decreased over time.
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; Department of Medicine, University of Colorado Denver, Aurora, Colorado. Electronic address: emily.x.schroeder@kp.org.
Emily B
EB
Schroeder
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; Department of Family Medicine, University of Colorado Aurora, Denver, Colorado.
Elizabeth A
EA
Bayliss
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; Department of Medicine, University of Colorado Denver, Aurora, Colorado.
Stacie L
SL
Daugherty
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; Department of Medicine, University of Colorado Denver, Aurora, Colorado.
John F
JF
Steiner
D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood; D019033:Delivery of Health Care, Integrated; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007328:Insulin