Abstract
Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men. Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM. Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P < 0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups. Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.
Highlights
Type 2 diabetes (T2DM) is a powerful cardiovascular disease (CVD) risk factor in both men and women
The overall CVD risk is higher in T2DM men, the relative risk of coronary heart disease (CHD) is higher in T2DM women when compared to nondiabetic ones, with the loss of the typical oestrogen protection in the premenopausal state [1,2,3]
Analysis of lipid profile revealed that women had significantly higher mean total-cholesterol (T-C), Low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) serum levels compared to men (P < 0.0001 for all comparisons)
Summary
Type 2 diabetes (T2DM) is a powerful cardiovascular disease (CVD) risk factor in both men and women. The mechanism underlying this excessive CHD risk in women with type 2 diabetes (T2DM) has not been fully elucidated yet, several hypotheses suggest that diabetes per se may be a stronger CHD risk factor in the female gender, determining a more unfavourable CHD risk profile [4, 5] This could lead to more complex risk factors and/or disease management in women with T2DM as compared to men. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men To men, they do not receive medications despite high LDL-C. They do not receive medications despite high LDL-C These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk
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