LOS ANGELES — Women with type 2 diabetes may be treated for dyslipidemia less aggressively than men, and therefore may be at higher risk of developing cardiovascular disease, Dr. Quyen Ngo-Metzger reported at the annual meeting of the Society of General Internal Medicine.
Coronary heart disease (CHD) is a leading cause of death among women and among all patients with type 2 diabetes. Diabetes confers a four times greater risk of CHD in women, compared with a doubling of risk in men, said Dr. Ngo-Metzker, of the University of California, Irvine.
She and her associates examined quality of care in a sample of 4,879 men and 7,654 women with type 2 diabetes (mean age 56 years) who were treated at 16 Kaiser Permanente Georgia practices in 2002. About two-thirds of men and women received recommended hemoglobin A1c and cholesterol testing. About one-quarter of men (25%) and women (27%) achieved glycemic control (a hemoglobin A1c value of less than 7%).
Overall, 72% of men and 68% of women achieved LDL-cholesterol levels of less than 130 mg/dL, a statistically significantdifference. After adjustment for age and comorbid conditions in multivariate analyses, men were 26% more likely than women to have an LDL-cholesterol value of less than 130 mg/dL.
Among high-risk patients with known CHD, 86% of men and 76% of women had an LDL-cholesterol level of less than 130 mg/dL; after adjustment for age and comorbidity, men were twice as likely as women to have lipid control at this cutoff. In addition, 56% of men and 44% of women had an LDL-cholesterol level of less than 100 mg/dL; after adjustment, men were 64% more likely than women to have achieved control using this more stringent definition.
Forty-three percent of men were prescribed statins, versus 37% of women; this difference was statistically significant. Future research is needed, she noted, to determine whether the differences reflect providers' prescribing habits or personal preferences among women and men.