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Risk of Diabetes-related Complications Higher in Men than Women: Daily Dose
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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
Last week, we reported on findings from a study published in the Journal of Epidemiology & Community Health that examined the sex differences in incident microvascular and macrovascular complications among adults with diabetes and the impact of diabetes on duration on sex differences.
The study
Researchers assessed survey responses from the 45 and Up Study, a large prospective study of 267 357 men and women aged over 45 years living in New South Wales, Australia. These responses were linked to medical records, according to the study.
Diabetes-related complications included CVD (eg, ischemic heart disease, stroke, heart failure, diabetic cardiomyopathy, transient ischemic attack [TIA], eye issues (eg, diabetic retinopathy, cataract), lower limb issues (eg, peripheral neuropathy, ulcers, cellulitis, Charcot foot, osteomyelitis, peripheral vascular disease, and minor or major amputation), and kidney problems (eg, acute kidney failure, chronic kidney disease, unspecified kidney failure, dialysis, and kidney transplant).
The final sample included 25 713 individuals with diabetes at baseline. Nearly half of the cohort was aged 60 to 74 years and 57% were men.
The findings
During 177 851 person-years of follow-up, the overall incidence rates per 1000 person-years for CVD, eye, lower limb, and kidney complications were 37, 52, 21, and 32, respectively.
Men had a greater risk of CVD (adjusted hazard ratio [aHR] 1.51, 95% CI 1.43-1.59), lower limb (aHR 1.47, 95% CI 1.38-1.57), and kidney (aHR 1.55, 95% CI 1.47-1.64) complications than women. Men also had a higher risk of diabetic retinopathy (aHR 1.14, 95% CI 1.03-1.26).
Over a 10-year period, a higher percentage of men experienced CVD (44%), eye (57%), lower limb (25%), and kidney (35%) complications compared to women (31%, 61%, 18%, and 25%, respectively).
Diabetes duration (<10 years vs ≥10 years) did not substantially affect the sex differences in complications.
Authors' comment
"Given the high rates of complication in both sexes, this study highlights the importance of targeted complication screening and prevention strategies from the time of diagnosis."
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