Issue 172 Item 6 Older Male Diabetics Have Better Risk Factor Control than Women

Elderly men with diabetes have better control of blood pressure, lipid levels, and hypoglycemia than older female diabetics, despite nearly similar drug treatment.

Dr. Peter M. Nillson, University Hospital, Huddinge, Sweden, and colleagues assessed the risk factor control and treatment profile in 9,373 diabetics who were treated at 229 primary health care centers.

"While gender differences in the use of diagnostic procedures, control of risk factors, and the treatment profile in patients with cardiovascular disease have been widely studied in recent years, there is little information on gender differences in the management of diabetic patients treated in a primary care setting," Dr. Nillson pointed out.

Results showed that 44% of men in the 60 to 75 year age range reached a target blood pressure of less than 140/85 mm Hg versus 59% of women in this age group (P<.01). Men also had superior glycemic control, defined as a hemoglobin A1 C level below 6.5% (P<.01).

The study also documented higher levels of total (P<.01) and high-density lipoprotein cholesterol (P<.05) than men in all age groups. Patients were classified into three groups by age: under 59 years of age, 60 to 75 years, and 76 years or older.

Men and women in the youngest and oldest age groups did not differ with respect to low-density lipoprotein (LDL)-cholesterol level. However, women in the 60 to 75 year group had a significantly higher mean LDL-cholesterol level than men ( 3.3 mmol/L versus 3.2 mmol/L for the two groups, respectively, P<.05).

Overall, prior ischemic heart disease and microalbuminuria were more common in men of all age groups compared to women (P<.01).

There were no male/female differences with respect to LDL-cholesterol in patients taking lipid-lowering drugs.

"The results show that male diabetics over 60 years of age had better risk factor control than corresponding female patients despite the fact that the two groups tended to use the same lipid lowering and anti-diabetic drugs," Dr. Nillson said. The sole difference in drug therapy between the genders was that older men tended to use more angiotensin-converting-enzyme inhibitors.

The study was sponsored by Merck Sweden in Stockholm.

IDF: [Study title: Gender differences in risk factor control and treatment profile in Type 2 diabetes – a national study in the primary health care of Sweden. Abstract 2901.]

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