A study show that women with diabetes are still in a high risk category with absolutely no show of decline in their death rate. All the advances in medical science have reduced cardiovascular diseases to quite an extent and extended lives. But sadly it does not seem to apply to women with diabetes.
The rate of premature death among American men with diabetes has dropped dramatically over the last few decades.
AdvertisementThe proportion of early deaths among diabetic women remained unchanged between 1971 and 2000, say Centers for Disease Control and Prevention researchers, whose findings were published online today in the Annals of Internal Medicine.
It's not clear why the discrepancy exists. "I do not have a clue," said Dr. Larry Deeb, president of medicine and science for the American Diabetes Association (ADA), when asked why women are falling behind. "But I do know that it argues that something we're doing isn't right. If you're a woman, and you have diabetes, it may be we're not aggressive enough about taking care of you."
The researchers looked at about 27,000 people.
They found that among diabetic men, the death rate from all causes dipped from 42.6 to 24.4 deaths per 1,000 persons between the two time periods.
Among men, "their mortality rates have declined," Gregg said, "and they've kept pace with their non-diabetic counterparts." But among diabetic women, the death rate actually rose from 18.4 to 25.9 per 1,000, even as the life span of non-diabetic women grew longer.
The death rate from cardiovascular disease (CVD), the most common cause of death in diabetics, fell for men to 12.8 per 1,000 from 26.4. These drops paralleled declining death rates among both men and women without diabetes in the U.S. population (down to 9.5 per 1,000 from 14.4) over the three-decade period.
Cardiologist Nanette Wenger of Emory University, Atlanta, suggests diabetic women who have heart disease are less likely to get aggressive treatment than men.
Diabetic women are diagnosed with heart disease later in their illness, receive less preventive care and are less likely to be treated properly for high cholesterol. Diabetes, which doubles the risk for heart disease, is occurring at younger ages than in previous generations, mainly because of increasing obesity.
"Clearly, women with diabetes deserve much more attention than they receive," endocrinologist Ronald Goldberg of the Diabetes Research Institute in Miami says. "To some degree, this is an obstacle to aggressive therapy, because physicians have traditionally thought of pre-menopausal women as at lower risk" for heart disease," he adds An estimated 9.7 million American women have diabetes, and almost one-third of them don't know it. Women with diabetes are more likely to have a heart attack, and at a younger age, than women without diabetes.
Diabetes is at least two to four times more common among black, Hispanic, American Indian, and Asian/Pacific Islander women than white women. The risk for the disease increases with age. Given the increasing life span of women and the rapid growth of minority populations, the number of women in the United States at risk for diabetes is increasing.
There are some clear cut discrepancies in a similar study conducted in Canada.
The gender gap found in the U.S. diabetic population can't necessarily be extrapolated to Canada, said Toronto endocrinologist Dr. Lorraine Lipscombe.
In a study she co-authored as a researcher at the Institute for Clinical Evaluative Sciences, published in March, Lipscombe said death due to the complications of diabetes in Ontario fell for both men and women between 1995 and 2005.
"In our study we did not find any difference between men and women and we found an overall decline of about 25 per cent," said Lipscombe.
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