December 01, 2014
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Preventive interventions effective for men, women with prediabetes

Behavioral and drug interventions in patients with prediabetes are equally effective in men and women at preventing progression to type 2 diabetes and reducing weight, according to research published in Diabetologia.

“Overall, based on data from more than 5,500 men and 7,400 women, our review did not find any relevant sex-specific differences in treatment effects during 1 to 6 years of active interventions,” the researchers wrote.

Anna Glechner, MD, of Danube University Krems, Austria, and colleagues searched PubMed, the Cochrane Library, Embase, CINAHL, Web of Science and reference lists of pertinent review articles from 1980 to June 2013; 12 studies were selected to examine how lifestyle interventions and glucose-lowering medications affected men and women.

“To the best of our knowledge, this is the first systematic review that assessed potential sex-specific differences in effects of preventive interventions in prediabetic people,” the researchers wrote.

The investigators used random-effects meta-analyses of published and unpublished data to determine differences of treatment effects between sexes.

Compared with usual care, men and women who received lifestyle interventions demonstrated:

  • Lower rate of progression to type 2 diabetes after 1 year (RR=0.6; 95% CI, 0.35-1.05) and 3 years (RR=0.63; 95% CI, 0.51-0.79);
  • Greater weight reduction (−2.45 kg; 95% CI, −3.56 to −1.33) after 3 years;
  • Greater reductions of fasting plasma glucose (−0.31 mmol/L; 95% CI, −0.48 to −0.15) after 3 years;
  • Improved 2-hour post-challenge-glucose (−0.68 mmol/L; 95% CI, −1.03 to −0.34) after 3 years.

No significant differences in treatment effects between sexes were apparent for any outcomes (P values of all comparisons ≥0.09).

“Despite differences in age of onset, detection and burden of type 2 diabetes between men and women, the effectiveness of preventive interventions in people with prediabetes is not influenced by gender,” the researchers wrote. “Consequently, clinicians and prevention managers can focus on factors that are known to determine the magnitude of beneficial effects, such as adherence.”

Disclosure: The study was funded by the Medical-Scientific Fund of the Mayor of Vienna. Please see study for full list of researchers’ financial disclosures.