GENDER GAP IN LIPID MANAGEMENT AMONGST DIABETES POPULATION: AN OBSERVATION
Main Article Content
Keywords
Gender gap, diabetes, therapeutics, goal attainment
Abstract
Studies have consistently demonstrated that women with diabetes are more likely than men to have a LDL-C above treatment goals. However, this pattern of gender gap has not been observed in many studies for HgbA1c goal attainment. Although the reasons for this are not fully understood, intolerance to statin therapy in women due to differences in pharmacodynamics and pharmacokinetics may play a role as female sex and aging has been associated with statin-associated myopathy. The concept of gender gap is useful for identifying at-risk groups for prevention and treatment efforts.
References
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20. Jha AK, Perlin JB, Steinman MA, Peabody JW, Ayanian JZ. Quality of ambulatory care for women and men in the Veterans Affairs Health Care System. J Gen Intern Med 2005;20:762 - 765.
21. Gobl CS, Brannath W, Bozkurt L, et al. Sex-specific differences in glycemic control and cardiovascular risk factors in older patients with insulin-treated type 2 diabetes mellitus. Gend Med 2010;7:593 - 599.
22. Farahani P, Thomas A, Elston - Lafata J. Racial and gender differences in HgbA1c and LDL - C goal attainment in patients with diabetes. Endocrine Reviews 2013;34:SUN - 816.
23. Rossi MC, Cristofaro MR, Gentile S, et al. Sex disparities in the quality of diabetes care: Biological and cultural factors may play a different role for different outcomes: A cross-sectional observational study from the AMD Annals Initiative. Diabetes Care 2013.
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25. Lewey J, Shrank WH, Bowry AD, Kilabuk E, Brennan TA, Choudhry NK. Gender and racial disparities in adherence to statin therapy: a meta-analysis. Am Heart J 2013;165:665 - 78, 678.
26. Bhattacharjee S, Findley PA, Sambamoorthi U. Understanding gender differences in statin use among elderly Medicare beneficiaries: an application of decomposition technique. Drugs Aging 2012;29:971 - 980.
27. Kasznicki J. Type 2 diabetic patients compliance with drug therapy and glycaemic control. Diabetologia Doœwiadczalna I Kliniczna 2007;7:199 - 203.
28. Ewenighi C. The effect of age, gender, level of adiposity and diabetes duration on glycated hemoglobin reduction after anti-diabetic therapy in type - 2 diabetic patients. Journal of Diabetes Mellitus 2012;2:245 - 250.
29. Franconi F, Brunelleschi S, Steardo L, Cuomo V. Gender differences in drug responses. Pharmacol Res 2007 ;55:81 - 95.
30. Bhardwaj S, Selvarajah S, Schneider EB. Muscular effects of statins in the elderly female: a review. Clin Interv Aging 2013;8:47 - 59.
31. Mancini GB, Baker S, Bergeron J, et al. Diagnosis, prevention, and management of statin adverse effects and intolerance: proceedings of a Canadian Working Group Consensus Conference. Can J Cardiol 2011;27:635 - 662.
32. Nolan M. Gender b arriers in p olicy and r egulation. J Popul Ther Clin Pharmacol 2013;20:e362 - e368.
33. Mattison D. Pharmacokinetics in r eal l ife: s ex and g ende r d ifferences. J Popul Ther Clin Pharmacol 2013;20:e340 - e349
2. Canadian Diabetes Association. The prevalence and costs of diabetes. http://www diabetes ca/diabetes - and - you/what/prevalence/ [serial online] 2013.
3. IDF. The Global Burden. http://www idf org/sites/default/files/The_Global_Burden pdf [serial online] 2013.
4. Anderson TJ, Gregoire J, Hegele RA, et al. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol 2013;29:151 - 167.
5. Canadian Diabetes Association. Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37:S1 - S212.
6. Hackam DG, Quinn RR, Ravani P, et al. The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 2013;29:528 - 542.
7. Farahani P, Levine M. Goal attainment for multiple cardiovascular risk factors in community-based clinical practice (a Canadian experience). J Eval Clin Pract 2009;15:212 - 216.
8. Leiter LA, Berard L, Bowering CK, et al. Type 2 diabetes mellitus management in Canada: Is it improving? Can J Diabetes 2013;37:82 - 89.
9. Nichols GA, Joshua - Gotlib S, Parasuraman S. Independent contribution of A1C, systolic blood pressure, and LDL cholesterol control to risk of cardiovascular disease hospitalizations in type 2 diabetes: an observational cohort study. J Gen Intern Med 2013;28:691 - 697.
10. Centers for Disease Control and Prevention. CDC Health Disparities and Inequalities Report - United States. MMWR 2011;60 (Suppl).
11. Golden SH, Brown A, Cauley JA, et al. Health disparities in endocrine disorders: biological, clinical, and nonclinical factors -- an Endocrine Society scientific statement. J Clin Endocrinol Metab 2012;97:E1579 - E1639.
12. Saffar D, Williams K, Lafata JE, Divine G, Pladevall M. Racial disparities in lipid control in patients with diabetes. Am J Manag Care 2012;18:303 - 311.
13. Vimalananda VG, Miller DR, Palnati M, Christiansen CL, Fincke BG. Gender disparities in lipid-lowering therapy among veterans with diabetes. Women's Health Issues 2011;21:S176 - S181.
14. Correa - de - Araujo R, Stevens B, Moy E, Nilasena D, Chesley F, McDermott K. Gender differences across racial and ethnic groups in the quality of care for acute myocardial infarction and heart failure associated with comorbidities. Women's Health Issues 2006;16:44 - 55.
15. Chang AM, Mumma B, Sease KL, Robey JL, Shofer FS, Hollander JE. Gender bias in cardiovascular testing persists after adjustment for presenting characteristics and cardiac risk. Acad Emerg Med 2007;14:599 - 605.
16. Gouni - Berthold I, Berthold HK, Mantzoros CS, Bohm M, Krone W. Sex disparities in the treatment and control of cardiovascular risk factors in type 2 diabetes. Diabetes Care 2008;31:1389 - 1391.
17. Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ 2006;332:73 - 78.
18. Sheifer SE, Escarce JJ, Schulman KA. Race and sex differences in the management of coronary artery disease. Am Heart J 2000;139:848 - 857.
19. Yu MK, Lyles CR, Bent - Shaw LA, Young BA. Sex disparities in diabetes process of care measures and self - care in high - risk patients. J Diabetes Res 2013;2013:575814.
20. Jha AK, Perlin JB, Steinman MA, Peabody JW, Ayanian JZ. Quality of ambulatory care for women and men in the Veterans Affairs Health Care System. J Gen Intern Med 2005;20:762 - 765.
21. Gobl CS, Brannath W, Bozkurt L, et al. Sex-specific differences in glycemic control and cardiovascular risk factors in older patients with insulin-treated type 2 diabetes mellitus. Gend Med 2010;7:593 - 599.
22. Farahani P, Thomas A, Elston - Lafata J. Racial and gender differences in HgbA1c and LDL - C goal attainment in patients with diabetes. Endocrine Reviews 2013;34:SUN - 816.
23. Rossi MC, Cristofaro MR, Gentile S, et al. Sex disparities in the quality of diabetes care: Biological and cultural factors may play a different role for different outcomes: A cross-sectional observational study from the AMD Annals Initiative. Diabetes Care 2013.
24. Dale KM, Coleman CI, Shah SA, Patel AA, Kluger J, White CM. Impact of gender on statin efficacy. Curr Med Res Opin 2007;23:565 - 574.
25. Lewey J, Shrank WH, Bowry AD, Kilabuk E, Brennan TA, Choudhry NK. Gender and racial disparities in adherence to statin therapy: a meta-analysis. Am Heart J 2013;165:665 - 78, 678.
26. Bhattacharjee S, Findley PA, Sambamoorthi U. Understanding gender differences in statin use among elderly Medicare beneficiaries: an application of decomposition technique. Drugs Aging 2012;29:971 - 980.
27. Kasznicki J. Type 2 diabetic patients compliance with drug therapy and glycaemic control. Diabetologia Doœwiadczalna I Kliniczna 2007;7:199 - 203.
28. Ewenighi C. The effect of age, gender, level of adiposity and diabetes duration on glycated hemoglobin reduction after anti-diabetic therapy in type - 2 diabetic patients. Journal of Diabetes Mellitus 2012;2:245 - 250.
29. Franconi F, Brunelleschi S, Steardo L, Cuomo V. Gender differences in drug responses. Pharmacol Res 2007 ;55:81 - 95.
30. Bhardwaj S, Selvarajah S, Schneider EB. Muscular effects of statins in the elderly female: a review. Clin Interv Aging 2013;8:47 - 59.
31. Mancini GB, Baker S, Bergeron J, et al. Diagnosis, prevention, and management of statin adverse effects and intolerance: proceedings of a Canadian Working Group Consensus Conference. Can J Cardiol 2011;27:635 - 662.
32. Nolan M. Gender b arriers in p olicy and r egulation. J Popul Ther Clin Pharmacol 2013;20:e362 - e368.
33. Mattison D. Pharmacokinetics in r eal l ife: s ex and g ende r d ifferences. J Popul Ther Clin Pharmacol 2013;20:e340 - e349