Gender differences in cardiovascular disease risk factors, treatments and complications in patients with type 2 diabetes: the RIACE Italian multicentre study
Article first published online: 21 APR 2013
© 2013 The Association for the Publication of the Journal of Internal Medicine
Journal of Internal Medicine
Volume 274, Issue 2, pages 176–191, August 2013
How to Cite
University of Pisa, Pisa, Italy; University of Verona, Verona, Italy; University of Siena, Siena, Italy; Fondazione IRCCS ‘Cà Granda – Ospedale Maggiore Policlinico’, Milan, Italy; San Raffaele Scientific Institute, Milan, Italy; Hospital of Bergamo, Bergamo, Italy; University of Padua, Padua, Italy; University of Turin, Turin, Italy; University of Bari, Bari, Italy; Consorzio Mario Negri Sud, S. Maria Imbaro, Italy; La Sapienza’ University, Rome, Italy). Gender differences in cardiovascular disease risk factors, treatments and complications in patients with type 2 diabetes: the RIACE Italian multicentre study. J Intern Med 2013; 274: 176–191., , , , , , , , , , ,
- Issue published online: 12 JUL 2013
- Article first published online: 21 APR 2013
- Accepted manuscript online: 9 APR 2013 05:36AM EST
- cardiovascular disease risk factors;
- treatment disparities;
- type 2 diabetes
Poorer control of risk factors for cardiovascular disease (CVD) has been reported in diabetic women, as compared with diabetic men. It has been proposed that this finding is due to gender disparities in treatment intensity. We investigated this hypothesis in a large contemporary cohort of subjects with type 2 diabetes.
Observational, cross-sectional study.
Subjects and setting
Consecutive patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian multicentre study (n = 15 773), attending 19 hospital-based diabetes clinics in 2007–2008.
Main outcome measures
Traditional CVD risk factors, macro- and microvascular complications and current glucose-, lipid- and blood pressure (BP)-lowering treatments were assessed.
Although CVD was more prevalent in men, women showed a less favourable CVD risk profile and worse performance in achieving treatment targets for haemoglobin A1c, LDL, HDL and non-HDL cholesterol, systolic blood pressure (BP) and in particular obesity [body mass index (BMI) and waist circumference], but not for triglycerides and diastolic BP. However, women were more frequently receiving pharmacological treatment for hypertension and to a lesser extent hyperglycaemia and dyslipidaemia than men, and female gender remained an independent predictor of unmet therapeutic targets after adjustment for confounders such as treatments, BMI, duration of diabetes and, except for the systolic BP goal, age.
In women with type 2 diabetes from the RIACE cohort, a more adverse CVD risk profile and a higher likelihood of failing treatment targets, compared with men, were not associated with treatment differences. This suggests that factors other than gender disparities in treatment intensity are responsible.