New research shows gender matters when it comes to the risk of dying from diabetes.
Researchers from the Centers for Disease Control and Prevention did an analysis of three large databases that included 29 years between 1971 and 2000. Results show the death rate of men who have diabetes dropped steeply during that period, but for women, death rates did not decline at all.
Edward Gregg, Ph.D., from the CDC, reported, “The improvements seen in men suggest that the improvements in diabetes care are working on longevity as well. But the finding in women is concerning and means we may need to explore whether different approaches are needed to improve health outcomes for women with diabetes.”
Specifically, researchers found the death rate among men with diabetes fell from 42.6 per 1,000 people to 24.4 per 1,000 people. That translates to a 43-percent relative reduction in risk of death. Among diabetic men, the death rate from heart disease — which is the leading killer among diabetics — dropped from 26.4 to 12.8. Death rates among women did not drop.
The reasons for the gender disparity are unclear, wrote study authors, as the study was not designed to determine why there are sex-related differences in death rates.
“Some studies have suggested women have had less improvement in heart disease risk factors in recent years. Other studies suggest women receive less aggressive care for heart disease and risk factors. Still other studies suggest that heart disease and diabetes may take a subtly different form in women and that different types of treatments are needed,” Dr. Gregg reported in a press release issued by the American College of Physicians.
Massachusetts General Hospital researcher Deborah Wexler, M.D., told Ivanhoe she saw another interesting possibility in the data presented in the study. She noted the poverty income ratios for men with diabetes decreased during the study period, from 25.2 to 17.2, while the poverty income ratios for women with diabetes increased slightly, from 27.2 to 29.8.
“Poverty may be a very important confounder of increased mortality risk,” Dr. Wexler said. Though the study authors suggest the differences in how doctors treat patients of each gender may, in part, explain the gap, Dr. Wexler said there is another explanation. “This study really suggests that might not have been the doctors at all, that this really is a socio-economic issue.”
Dr. Wexler is part of the Diabetes Unit at Massachusetts General Hospital in Boston. She was not a part of this study but has previously published research on gender disparities in diabetes care.
SOURCE: Ivanhoe interview with Deborah Wexler, M.D.; Annals of Internal Medicine, published online June 18, 2007
