Gender disparities in diabetes and coronary heart disease medication among patients with type 2 diabetes: results from the DIANA study
- Equal contributors
1 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany
2 Practice of General Medicine, Blumenstrasse 11, D-71726, Benningen/ Neckar, Germany
3 Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, D-89081, Ulm, Germany
4 Department of General Practice and Health Services Research, University of Zürich, University Hospital of Zürich, Pestalozzistrasse 24, CH-8091, Zürich, Switzerland
5 Department of General Practice and Health Services Research, University Hospital Heidelberg, Vossstrasse 2, Geb. 37, D-69115, Heidelberg, Germany
Cardiovascular Diabetology 2012, 11:88 doi:10.1186/1475-2840-11-88Published: 27 July 2012
Coronary heart disease (CHD) is one of the most common long-term complications in people with type 2 diabetes. We analyzed whether or not gender differences exist in diabetes and CHD medication among people with type 2 diabetes.
The study was based on data from the baseline examination of the DIANA study, a prospective cohort study of 1,146 patients with type 2 diabetes conducted in South-West Germany. Information on diabetes and CHD medication was obtained from the physician questionnaires. Bivariate and multivariate analyses using logistic regression were employed in order to assess associations between gender and prescribed drug classes.
In total, 624 men and 522 women with type 2 diabetes with a mean age of 67.2 and 69.7 years, respectively, were included in this analysis. Compared to women, men had more angiopathic risk factors, including smoking, alcohol consumption and worse glycemic control, and had more often a diagnosed CHD. Bivariate analyses showed higher prescription of thiazolidinediones and oral combination drugs as well as of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers and aspirin in men than in women. After full adjustment, differences between men and women remained significant only for ACE inhibitors (OR = 1.44; 95%-confidence interval (CI): 1.11 – 1.88) and calcium channel blockers (OR = 1.42, 95%-CI: 1.05 – 1.91).
These findings contribute to current discussions on gender differences in diabetes care. Men with diabetes are significantly more likely to receive oral combination drugs, ACE inhibitors and calcium channel blockers in the presence of coronary heart disease, respectively. Our results suggest, that diabetic men might be more thoroughly treated compared to women. Further research is needed to focus on reasons for these differences mainly in treatment of cardiovascular diseases to improve quality of care.