The Problem of Diabetes and Cardiovascular Disease: Include Women in the Solution

Abstract

Do men and women with diabetes fare equally in cardiovascular disease (CVD) prevention and mortality? It appears that they do not. Although mortality from CVD is on the decline,1 women with diabetes are 2.5 times more likely to develop CVD and 2.2 times more likely to die from CVD than nondiabetic women.2 The favorable reductions in all-cause and CVD mortality among individuals with diabetes during the past few decades have not been shared equally by men and women.3 From 1971 to 2000, mortality rates from CVD and all-cause mortality declined significantly among men with diabetes, but not among women with diabetes. The same study showed that all-cause mortality for women with diabetes was double that of women without diabetes.3 The gender gap may be narrowing, however. In a recent study, there was an equal reduction in CVD mortality in men and women with diabetes between 1997 and 2006.4,5 The mortality gap between hospitalized myocardial infarction (MI) patients with and without diabetes also narrowed during this time period, with the greatest improvements in women with diabetes.6 Despite the substantially increased CVD risk in both men and women with diabetes, 30–50% of individuals with diabetes do not meet individual targets for risk modification. …