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LDL management worse among women with type 2 diabetes
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Women with type 2 diabetes are more likely to have out-of-target LDL cholesterol levels than men, according to a research article in the International Journal of Endocrinology.
The finding was not affected by age, disease duration or use of lipid-lowering medications.
“The most striking finding of our study is that [type 2 diabetes] women were not [as] able to reach the recommended LDL [cholesterol] targets as men, in spite of a similar rate in the use of medications and a slightly higher use of statins,” the researchers wrote. “These differences were observed in each age group and in spite of diabetes duration.”
Giuseppina Russo, MD, of University of Messina, Italy, and colleagues at other institutions analyzed data from 412,299 patients with type 2 diabetes attending diabetes clinics in 2009 collected during the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi) Annals Initiative.
Analysis of lipid profiles revealed that women had higher mean total cholesterol (194.1 ± 40.9 mg/dL women; 182.3 ± 40.8 mg/dL men; P < .0001), LDL cholesterol (112.5 ± 34.8 mg/dL women; 106.6 ± 34.4 mg/dL men; P < .0001) and HDL cholesterol (53.3 ± 14 mg/dL women; 46.3 ± 12.6 mg/dL men; P < .0001) serum levels when compared with men. Women also showed higher HbA1c levels when compared with men (58 ± 16.4 mmol/mol, women; 57 ± 16.4 mmol/mol, men; P < .0001).
The disparity in reaching LDL cholesterol targets increased with age and length of diabetes duration.
The researchers identified several possible explanations for the data. Women may be less adherent to treatments or a treatment bias in favor of men exists. Researchers also suggested that LDL cholesterol levels may be different because of different titration of lipid-lowering drugs. Women also could face more social barriers and a lower understanding of the importance of their cardiovascular disease risk compared with men.
“This low perception could be worsened by the presence of stress and lack of time for self-care due to child care, elder care and increasing work activities,” the researchers wrote.
Although sex-specific differences in the pharmacodynamics of drugs are still unclear, there could be a sex-specific lipid-lowering resistance that explains a woman’s higher risk for worse lipid profiles, according to researchers.
“Health care professionals should advise women with [type 2 diabetes] about their potential CVD risk, and should not give priority only on treating hyperglycemia and diabetes-related symptoms,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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