Sex inequalities in cardiovascular risk factors and their management in primary prevention in adults living with type 1 diabetes in Germany and France: findings from DPV and SFDT1
Year: 2024
Type: article
Abstract: INTRODUCTION & OBJECTIVES: To evaluate whether cardiovascular risk factors and their management differ in primary prevention between adult males and females with type 1 diabetes (T1D) in two European countries in 2020-2022 and sex inequalities in achievement of standards of care in diabetes. METHODS: We used 2020-2022 data of patients without a cardiovascular history in the Prospective Diabetes Follow-up registry (DPV) centres, in Germany, and the Société Francophone du Diabète- Cohorte Diabète de Type 1 cohort (SFDT1), in France. RESULTS: We included 2,657 participants from the DPV registry and 1,172 from the SFDT1 study. Body mass indexes were similar in females and males with similar proportions of HbA1c < 7% (DPV: 36.6 vs 33.0%, p = 0.06, respectively; SFDT1: 23.4 vs 25.7%, p = 0.41). Females were less overweight compared to men in DPV (55.4 vs 61.0%, p < 0.01) but not in SFDT1 (48.0 vs 44.9%, p = 0.33) and were less prone to smoke (DPV: 19.7 vs 25.8%, p < 0.01; SFDT1: 21.0 vs 26.0%, p = 0.07). Systolic blood pressure was lower in females than males with a higher rate of antihypertensive therapy in case of hypertension in females in DPV (70.5 vs 63.7%, p = 0.02) but not in SFDT1 (73.3 vs 68.6%, p = 0.64). In the case of microalbuminuria, ACEi-ARB were less often prescribed in women than men in DPV (21.4 vs 37.6%, p < 0.01) but not SFDT1 (73.3 vs 67.5.0%, p = 0.43). In females compared to males, HDL-cholesterol levels were higher; triglycerides were lower in both countries. In those with LDL-cholesterol > 3.4 mmol/L (DPV: 19.9 (females) vs 23.9% (males), p = 0.01; SFDT1 17.0 vs 19.2%, p = 0.43), statin therapy was less often prescribed in females than males in DPV (7.9 vs 17.0%, p < 0.01), SFDT1 (18.2 vs 21.0%, p = 0.42). CONCLUSION: In both studies, females in primary prevention have a better cardiovascular risk profile than males. We observed a high rate of therapeutic inertia, which might be higher in females for statin treatment and nephroprotection with ACEi-ARB, especially in Germany. Diabetologists should be aware of sex-specific differences in the management of cardiorenal risk factors to develop more personalized prevention strategies.
Source: Cardiovascular Diabetology
Authors: Emmanuel Cosson, Marie Auzanneau, Gloria A. Aguayo, Wolfram Karges, Jean-Pierre Riveline, Petra Augstein, Laura Sablone, Peter Jehle, Guy Fagherazzi, Reinhard W. Holl, for the DPV initiative and the SFDT1 study group
Institutions: Inserm, Université Paris Cité, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Sorbonne Paris Nord, Sorbonne Paris Cité, Assistance Publique – Hôpitaux de Paris, Hôpital Avicenne, Hôtel-Dieu de Paris, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche Épidémiologie et Statistique, Universität Ulm, German Center for Diabetes Research, Luxembourg Institute of Health, Universitätsklinikum Aachen, RWTH Aachen University, Hôpital Necker-Enfants Malades, Centre National de la Recherche Scientifique, Institut Necker Enfants Malades, Hôpital Fernand-Widal, Hôpital Lariboisière, Institute for Diabetes Gerhardt Katsch, Fondation Francophone pour la Recherche sur le Diabète, Martin Luther University Halle-Wittenberg
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,990
Funders: Eli Lilly and Company, Sanofi, Insulet Corporation, Dexcom, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Fondation Francophone pour la Recherche sur le Diabète, Bundesministerium für Bildung und Forschung, Novo Nordisk, Société Francophone du Diabète, Robert Koch Institut
Award: G3535376899
OpenAlex ID: W4402581048