title: Sex differences in cardiovascular outcomes, pharmacological treatments and indicators of care in patients with newly diagnosed diabetes: Analyses on administrative database.
abstract: BACKGROUND
  The impact of diabetes on cardiovascular disease in both sexes is known, but the specifics have not been fully clarified. We investigated whether sex-related differences exist in terms of management and hospitalization in patients with newly diagnosed diabetes.
  
  
  METHODS
  We examined the rates of hospitalization for cardiovascular causes, mortality, treatments and management of patients with diabetes compared to subjects without, from administrative database. Interaction between sex and diabetes on clinical outcomes were calculated using a Cox regression model. Pharmacological treatments and recommended examinations by sex were calculated using logistic regression.
  
  
  RESULTS
  From 2002 to 2006, 158,426 patients with diabetes and 314,115 subjects without were identified and followed up for a mean of 33 months (± 17.5). Diabetes confers a higher risk for all clinical outcomes. Females with diabetes have a risk profile for hospitalization for coronary heart disease comparable to males without (4.6% and 5.3%). Interaction between sex and diabetes shows that females with diabetes had an added 19% higher risk of total death (95% CI 1.13-1.24). No differences were observed in hospitalizations, although females with diabetes were less likely to undergo revascularization after myocardial infarction. Females received cardiovascular prevention drugs less frequently than males and had a slight tendency to get fewer examinations.
  
  
  CONCLUSIONS
  Diabetes is linked to a higher increase of mortality in females relative to males. This might reflect sex differences in the use of revascularization procedures or therapeutic regimens. Closer attention and implementation of standard care for females are necessary from the onset of diabetes.
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of General Practice Research, Milan, Italy. Electronic address: marta.baviera@marionegri.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Baviera
authors.affiliation: Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Scientific Direction and Emergency Medicine Dept, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Santalucia
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of General Practice Research, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cortesi
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of General Practice Research, Milan, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Marzona
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Geriatric Neuropsychiatry, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of General Practice Research, Milan, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Avanzini
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory for Quality Assessment of Geriatric Therapies and Services, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of Geriatric Neuropsychiatry, Milan, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Riva
authors.affiliation: Stroke Unit, University of Perugia, Santa Maria della Misericordia Hospital, Perugia, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.affiliation: Regional Health Ministry, Lombardy Region, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Laboratory of General Practice Research, Milan, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Roncaglioni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000628:therapy*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents
keywords: Cardiovascular outcome; Mortality; Newly diagnosed diabetes; Sex differences