Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC

Larkin, Mary E.; Backlund, Jye Yu C.; Cleary, Patricia A.; Bayless, M.; Schaefer, B.; Canady, Janene L.; Nathan, David M.

doi:10.1111/j.1464-5491.2010.02972.x

Cited by 41 publications

(30 citation statements)

References 24 publications

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“…[28][29][30][31] Somewhat counterintuitively, males had less use of statins, a finding at variance with the general population. 32,33 The rate of statin use we found, at 34.2 %, is broadly comparable to that found previous studies 18,34,35 ), and recent work utilizing Medicare Part D (at 44 %), 36 but is much higher than in older studies using data from the late 1990's when rates ranged from about 9-17 %, 15,[37][38][39][40] albeit at 16.6 % in U.S. patients. These rate variations likely reflect temporal trends in statin prescribing which reflect trends in the general population.…”

Section: Discussionsupporting

confidence: 85%

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

et al. 2012

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Section: Discussionsupporting

confidence: 85%

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

et al. 2012

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“…This effect of liraglutide is important because 40-50% of patients with type 1 diabetes in the US concomitantly have the metabolic syndrome (17). At 12 years of follow-up, 30% of patients with type 1 diabetes in Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Trial were obese (18). A similar high proportion of children (30%) with type 1 diabetes are either overweight or obese (19).…”

Section: Discussionmentioning

confidence: 99%

Liraglutide as additional treatment for type 1 diabetes

Varanasi

Bellini

Rawal

et al. 2011

European Journal of Endocrinology

126

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Objective: To determine whether the addition of liraglutide to insulin to treat patients with type 1 diabetes leads to an improvement in glycemic control and diminish glycemic variability. Subjects and methods: In this study, 14 patients with well-controlled type 1 diabetes on continuous glucose monitoring and intensive insulin therapy were treated with liraglutide for 1 week. Of the 14 patients, eight continued therapy for 24 weeks. Results: In all the 14 patients, mean fasting and mean weekly glucose concentrations significantly decreased after 1 week from 130G10 to 110G8 mg/dl (P!0.01) and from 137.5G20 to 115G12 mg/dl (P!0.01) respectively. Glycemic excursions significantly improved at 1 week. The mean S.D. of glucose concentrations decreased from 56G10 to 26G6 mg/dl (P!0.01) and the coefficient of variation decreased from 39.6G10 to 22.6G7 (P!0.01). There was a concomitant fall in the basal insulin from 24.5G6 to 16.5G6 units (P!0.01) and bolus insulin from 22.5G4 to 15.5G4 units (P!0.01). In patients who continued therapy with liraglutide for 24 weeks, mean fasting, mean weekly glucose concentrations, glycemic excursions, and basal and bolus insulin dose also significantly decreased (P!0.01). HbA1c decreased significantly at 24 weeks from 6.5 to 6.1% (PZ0.02), as did the body weight by 4.5G1.5 kg (PZ0.02). Conclusion: Liraglutide treatment provides an additional strategy for improving glycemic control in type 1 diabetes. It also leads to weight loss.

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“…Practice guidelines from the American Diabetes Association (ADA) and the American Heart Association (AHA) emphasize similar treatment targets for men and women except during pregnancy (American Diabetes Association, 2013; Mosca et al, 2011). Despite these recommendations, previous studies have indicated that women with diabetes are less likely than men with diabetes to achieve some cardiovascular risk factor targets (Bertoni et al, 2008; Bird et al, 2007; Casagrande, Fradkin, Saydah, Rust, & Cowie, 2013; Chou et al, 2007; Ferrara et al, 2008; Larkin et al, 2010; Tseng et al, 2006; Wexler, Grant, Meigs, Nathan, & Cagliero, 2005; Winston, Barr, Carrasquillo, Bertoni, & Shea, 2009). These studies have primarily been cross-sectional and studied individuals with prevalent diabetes, and so were unable to examine changes in risk factor control and management over time and were not able to study the crucial period immediately after diabetes diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Cardiovascular Risk Factors in Incident Diabetes

Schroeder

Bayliss

Daugherty

et al. 2014

Women's Health Issues

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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 ADA and AHA guidelines for control of cardiovascular risk factors (hemoglobin A1c, 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 one 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. Findings Compared with men, at baseline women had lower hemoglobin A1c (7.9% vs. 8.2%, P<0.001), higher LDL cholesterol (118.9 vs. 111.5 mg/dL, P < 0.001), higher systolic blood pressure (131.9 vs. 130.5 mmHg, P<0.001), and lower diastolic blood pressure (79.1 vs. 79.7 mmHg, P=0.006). At follow-up, the hemoglobin A1c gender gap had closed (6.9% vs. 6.9%, P=0.39), and the gender gaps had decreased for blood pressure (129.8/77.0 vs. 128.9/77.6, P=0.009) and LDL cholesterol (104.0 vs 98.2 mg/dL, P<0.001). 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.

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Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC

Abstract: In Type 1 diabetes, women report lower frequency than men in the use of interventions that decrease CHD risk. These findings are consistent with reports in the Type 2 diabetic population, showing that risk-reducing measures are underused in women with diabetes.

Cited by 41 publications

References 24 publications

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

Geographic Variation in HMG-CoA Reductase Inhibitor Use in Dialysis Patients

Liraglutide as additional treatment for type 1 diabetes

Gender Differences in Cardiovascular Risk Factors in Incident Diabetes

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