Gender-Related Differences in the Control of Cardiovascular Risk Factors in Primary Care for Elderly Patients With Type 2 Diabetes: A Cohort Study

Abstract

Objective: The aim of this study was to estimate the association between gender and control of diabetes and other cardiovascular risk factors in elderly patients with type 2 diabetes mellitus.

Methods: The sujets âgés cohort is an observational study whose main objective was to describe the real-life management of elderly patients with type 2 diabetes mellitus in France. Nine hundred eighty-three patients with diabetes (517 men and 466 women) were recruited by 213 general practitioners and were followed up prospectively every 6 months for 3 years. Diabetes, hypertension and dyslipidemia were considered controlled if the glycated hemoglobin (A1C) was ≤7%, blood pressure was <140/90 mm Hg and low-density lipoprotein (LDL) cholesterol was ≤100 mg/dL. A1C levels and blood pressure measurements were recorded every 6 months for all patients. LDL cholesterol levels were optionally sampled every year.

Results: Women were older than men (77.3±5.72 vs. 76.1±6.01 years), more likely to be alone, less likely to be smokers/ex-smokers and less likely to have cardiovascular disease at baseline. Mean A1C levels of female patients (6.98%±1.03%) did not differ from those of male patients (6.91%±0.96%). Mean blood pressure measurements during follow up were not different between male and female patients. In contrast, female patients had significantly higher LDL cholesterol levels than male counterparts (105.2±32.6 vs. 94.9±29.1 mg/dL), regardless of statin therapy.

Conclusion: Our results suggest no difference in the management of cardiovascular risk factors between elderly female patients with type 2 diabetes mellitus and their male counterparts, except for LDL cholesterol, which is significantly higher in women.

Keywords: cardiovascular complications of diabetes; cardiovascular risk factors; complications cardiovasculaires du diabète; diabetes mellitus; diabète sucré; différences entre les sexes; facteurs de risque cardiovasculaire; gender-related differences; primary care for the elderly; soins primaires pour les personnes âgées.