German researchers have found that women with type 2 diabetes and heart disease have poorer control of both diseases and are likely to receive less intense treatment for the same as compared to men.
Lead author Ioanna Gouni-Berthold, MD, professor of medicine at the University of Cologne, said that the findings may indicate why death due to heart disease has decreased among diabetic men but not in women with type 2 diabetes.
"Our study shows that in patients with diabetes there is a clear disparity between men and women in the control and treatment of important modifiable risk factors for cardiovascular disease," Gouni-Berthold said.
"Women have worse control of their blood pressure, blood sugar and cholesterol levels compared to men and are given cholesterol-lowering medications less often," she added.
Gouni-Berthold and researchers from the University of Bonn and University of Homburg studied nearly 45,000 people with type 2 diabetes treated as outpatients by private-practice physicians from 2002 to 2003.
Of the patients, 9,521 men and 8,050 women had heart and vascular disease.
The study showed that there were no gender differences in the intensity of medication management or most heart disease risk factors among diabetic patients who did not have heart disease.
However, in the group with cardiovascular disease, women were 44 percent more likely than men to have high LDL ("bad") cholesterol, yet 15 percent less likely to receive lipid-lowering medications, the researchers reported.
Women also were 19 percent more likely than men to have uncontrolled high blood pressure.
Besides this, women were 15 percent more likely to have poor long-term control of their blood glucose (sugar) level, as shown by a hemoglobin A1c blood test above 8 percent.
The recommended A1c level for adults with type 2 diabetes is less than 7 percent.
According to Gouni-Berthold, the findings are cause for concern because there is evidence that diabetes cancels the protective effect of female sex on the risk of heart disease.
"More aggressive treatment of cardiovascular disease in women with diabetes may improve the gender disparity in cardiovascular disease mortality. Patients should speak with their doctors about the intensity of treatment modalities," she said.
The results will be presented at The Endocrine Society's 90th Annual Meeting in San Francisco.