Sex Disparities in Treatment of Cardiac Risk Factors in Patients With Type 2 Diabetes

Wexler, Deborah J.; Grant, Richard W.; Meigs, James B.; Nathan, David M.; Cagliero, Enrico

doi:10.2337/diacare.28.3.514

Cited by 316 publications

(282 citation statements)

References 39 publications

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“…[6] Results of our study shows that the level of LDL, TC & TG were significantly higher in Type 2 diabetics, which is in accordance with the study conducted by Wexler et al [7] Diabetic patients with elevated HbA1c and altered Lipid profile can be considered as a very high risk group for severe complications. Improving glycemic control can substantially reduce the risk in diabetic patients.…”

Section: Discussionsupporting

confidence: 91%

Correlation between Glycated hemoglobin and Lipid profile in Type 2 Diabetic population of district Meerut, U.P.

Taliyan¹,

Nagtilak²,

Parashar³

et al. 2016

Int J of Biomed & Adv Res

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Background: The Type 2 diabetes mellitus is becoming more and more prevalent in our country India and it is estimated that approximately around 2% of the Indian population i.e around 15 million peoples are suffering from this disease and Glycated hemoglobin (HbA1c) is routinely used as a diagnostic tool for screening and measuring long term control in diabetic patient. Aim: The study was planned to observe the relationship among Glycated hemoglobin (HbA1c), Fasting blood sugar and Lipid profile in Type 2 diabetics of western U.P population. Material and Methods: Data of around 92 males and 112 females, from the age group of 25 to 55 years were selected from December 2014 to July 2016 in a cross sectional manner. Blood sample (3ml) was collected from each subject. Serum was separating by centrifuging blood at 3000 rpm for 10 min. Fasting blood sugar and Lipid profile were estimated by Vitros 250 auto analyzer using readymade dry chemistry kits from Ortho Clinical diagnostics, Johnson & Johnson, USA and HbA1c with kit based method. Result: Mean value of HbA1c in control subjects was 4.62± 0.18 and 5.78± 0.19 in diabetic subjects, HbA1c values were significantly higher in Diabetic subjects (<0.001) as compared to control subjects. The mean value of FBS in Diabetic subjects was 115.72± 3.83 and 92.33± 3.61 in control subjects. Also, FBS mean value was found to be significantly lower in control group (<0.001) as compared to Diabetic subjects. Conclusion: Our study demonstrates that, altered Lipid profile has been associated with elevated levels of Fasting blood glucose. Thus, the adverse effect of hyperglycemia and associated dyslipidemia must not be overlooked in Diabetic subjects.

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Section: Discussionsupporting

confidence: 91%

Correlation between Glycated hemoglobin and Lipid profile in Type 2 Diabetic population of district Meerut, U.P.

Taliyan¹,

Nagtilak²,

Parashar³

et al. 2016

Int J of Biomed & Adv Res

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“…Our observations are consistent with other population-based (Kerr et al, 2004;Saydah et al, 2004) and clinicbased studies Kennedy et al, 2005;Wexler et al, 2005) of the general population with Type 2 diabetes. Second, we found that similar and substantial numbers of diabetes patients with and without SMI in this study met criteria for the metabolic syndrome, a cluster of risk factors including elevated cholesterol and blood pressure along with obesity and hyperglycemia that has been associated with increased mortality overall and from CVD in men and heightened risk of CVD in women .…”

Section: Discussionsupporting

confidence: 82%

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Kreyenbuhl¹,

Dickerson²,

Medoff³

et al. 2006

Journal of Nervous &Amp; Mental Disease

103

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Cardiovascular disease is the leading cause of death in Type 2 diabetes, which commonly occurs in patients with serious mental illnesses (SMIs). We determined the extent to which patients with diabetes and SMI, relative to diabetes patients without SMI, met American Diabetes Association goals for cholesterol and blood pressure, met criteria for the metabolic syndrome, and were prescribed medications known to reduce cardiovascular events. We found that less than half of diabetes patients, both with and without SMI, met recommended goals for cholesterol levels; even fewer had adequate blood pressure control. In addition, a substantial proportion of all diabetes patients met metabolic syndrome criteria. However, diabetes patients with SMI were less likely to be prescribed cholesterol-lowering statin medications, angiotensin-converting enzyme inhibitors, and angiotensin receptor blocking agents than diabetes patients without SMI. Patients with both diabetes and SMI are treated less aggressively for high cardiovascular risk than diabetes patients without mental disorders. KeywordsType 2 diabetes; serious mental illness; cardiovascular risk; metabolic syndrome In 2002, Type 2 diabetes affected approximately 6.3% of the US population at an estimated cost of $132 billion (American Diabetes Association, 2003;Engelgau et al., 2004). Type 2 diabetes is associated with a twofold to fourfold increased risk for major cardiovascular events and is considered a coronary heart disease risk equivalent that confers a level of risk equal to that in patients with pre-existing cardiovascular disease (CVD; Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001). Cardiovascular and cerebrovascular complications of Type 2 diabetes account for 60% to 75% of deaths from this disease (Stamler et al., 1993). Metabolic abnormalities characteristic of Type 2 diabetes including insulin resistance and dyslipidemias contribute in part to the increased CVD risk, with emerging evidence suggesting that persistent hyperglycemia may also play a role (Nathan et al., 2003;Selvin et al., 2004 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript frequent co-occurrence of hypertension, overweight and obesity, smoking, and reduced physical activity in patients with diabetes confers an additive CVD risk that exceeds the sum of their risks individually (Wilson et al., 1998). There is also mounting evidence that the cluster of risk factors that comprise the metabolic syndrome increases the risk for cardiovascular mortality , and by definition, would be expected to occur disproportionately in people with Type 2 diabetes.Persons with serious mental illnesses such as schizophrenia have an increased risk for Type 2 diabetes (Dixon et al., 2000) and other co-occurring medical conditions. Life expectancy in people with schizophrenia is 20% shorter than that of the general population (Newman and Bland, 1991), with the excess mortality largely attributed to higher rates of CVD (Brown et al., 2000;Os...

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“…Also, more men than women (20-39 years) were taking antihypertensive medication. This is in line with a study reporting that fewer women than men were treated for modifiable risk factors of T2DM (31). Nevertheless, in our cohort, more women than men aged O40 years were taking antihypertensive medication.…”

Section: Discussionsupporting

confidence: 69%

Type 2 diabetes from pediatric to geriatric age: analysis of gender and obesity among 120 183 patients from the German/Austrian DPV database

Awa

Fach²,

Krakow

et al. 2012

European Journal of Endocrinology

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Aim: To characterize the clinical phenotype of type 2 diabetes mellitus (T2DM) with respect to age, gender, and BMI. Method: Anonymized data of 120 183 people with T2DM from the German/Austrian multicenter Diabetes Patienten Verlaufsdokumentation database were analyzed based on chronological age or age at diagnosis (0-19, 20-39, 40-59, 60-79, and R80 years). Age, gender, and BMI comparisons with clinical phenotype were made using c 2 and Kruskal-Wallis tests (SAS V9.2). Results: Of all the patients, 51.3% were male, average age was 67.1G12.7 years, and average disease duration was 9.9G9.1 years. More girls than boys were diagnosed during adolescence and more men than women during adulthood (20-60 years). No gender differences existed when age at diagnosis was R60 years. Patients were obese on average (BMI: 30.5G6.1 kg/m 2 ) and had significantly higher BMI values than German population peers. The BMI gap was widest in the younger age categories and closed with increasing age. Adult women were significantly more obese than men. Obese patients more often had elevated HbA1c (R7.5%), hypertension or dyslipidemia (irrespective of age), microalbuminuria (adults), or retinopathy (elderly) than nonobese patients. More men than women (20-60 years) had hypertension, dyslipidemia, or microalbuminuria while more women than men (R60 years) had hypertension or dyslipidemia. Conclusion: During puberty, more girls than boys were diagnosed with T2DM while during adulthood males predominated. T2DM manifested at comparatively lower BMI in males, and younger patients were more obese at diagnosis. Age, gender, and BMI were also associated with poor metabolic control and cardiovascular disease comorbidities/complications.

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Sex Disparities in Treatment of Cardiac Risk Factors in Patients With Type 2 Diabetes

Cited by 316 publications

References 39 publications

Correlation between Glycated hemoglobin and Lipid profile in Type 2 Diabetic population of district Meerut, U.P.

Correlation between Glycated hemoglobin and Lipid profile in Type 2 Diabetic population of district Meerut, U.P.

Extent and Management of Cardiovascular Risk Factors in Patients With Type 2 Diabetes and Serious Mental Illness

Type 2 diabetes from pediatric to geriatric age: analysis of gender and obesity among 120 183 patients from the German/Austrian DPV database

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