Research Article 
Disparity in management of diabetes and coronary heart disease risk factors by sex in DCCT/EDIC
M. E. Larkin, J.-Y. Backlund, P. Cleary, M. Bayless, B. Schaefer, J. Canady, D. M. Nathan and the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group
Diabetic Medicine, 2010, 27(4), 451-458. DOI: 10.1111/j.1464-5491.2010.02972.x
Abstract
Aims Coronary heart disease (CHD) is a major cause of morbidity and mortality in patients with diabetes. Sex disparity in the treatment of modifiable CHD risk factors in patients with Type2 diabetes has been reported previously; however, there is little comparable information in Type1 diabetes.
Methods We performed a cross-sectional analysis of 1153 subjects with Type1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort to compare achievement of metabolic and CHD risk factor goals and use of recommended risk factor interventions between the sexes.
Results Women were less likely than men to achieve glycated haemoglobin (HbA1c) <7.0% [adjusted odds ratio (AOR) 0.76, 95% confidence interval (CI) 0.57–0.995] or <8.0% (AOR 0.74, 95% CI 0.58–0.95). Achievement of target lipid levels was not significantly different between the sexes. As in the non-diabetic population, men had higher blood pressure. Women were significantly less likely than men to report using aspirin (AOR 0.77, 0.60–0.99) and angiotensin-converting enzyme (ACE) inhibitors or angiotensinII receptor blockers (ARBs) (AOR 0.62, 0.49–0.80) and statins (AOR 0.56, 0.43–0.73), even after adjusting for blood pressure and lipid levels, respectively. Reported use of statins was also lower in women than men in the subset that developed a low-density lipoprotein (LDL) cholesterol level >3.4mmol/l (39% vs. 60%, P<0.05).
Conclusions In Type1 diabetes, women report lower frequency than men in the use of interventions that decrease CHD risk. These findings are consistent with reports in the Type2 diabetic population, showing that risk-reducing measures are underused in women with diabetes.
ASCI-ID: 109-248
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Effect of sitagliptin on glucose control in adult patients with Type 1 diabetes: a pilot, double-blind, randomized, crossover trialDiabetic Medicine, 2011, 28(10), 1176-1181. DOI: 10.1111/j.1464-5491.2011.03331.x
Reproducibility of in vivo corneal confocal microscopy as a novel screening test for early diabetic sensorimotor polyneuropathyDiabetic Medicine, 2011, 28(10), 1253-1260. DOI: 10.1111/j.1464-5491.2011.03299.x
Incidence rate trends in childhood Type 1 diabetes in Yorkshire, UK 1978-2007: effects of deprivation and age at diagnosis in the south Asian and non-south Asian populationsDiabetic Medicine, 2011, 28(12), 1508-1513. DOI: 10.1111/j.1464-5491.2011.03413.x
Comparison of longitudinal point-of-care and high-performance liquid chromatography HbA1c measurements in a multi-centre trialDiabetic Medicine, 2011, 28(12), 1525-1529. DOI: 10.1111/j.1464-5491.2011.03404.x
Long-lasting immunogenicity and safety of a 2009 pandemic influenza A(H1N1) MF59-adjuvanted vaccine when co-administered with a 2009-2010 seasonal influenza vaccine in young patients with Type 1 diabetes mellitusDiabetic Medicine, 2011, 28(12), 1530-1536. DOI: 10.1111/j.1464-5491.2011.03449.x
Type 1 diabetes education and care: time for a rethink?Diabetic Medicine, 2012, 29(2), 159-160. DOI: 10.1111/j.1464-5491.2011.03518.x
Understanding issues associated with attending a young adult diabetes clinic: a case studyDiabetic Medicine, 2012, 29(2), 257-259. DOI: 10.1111/j.1464-5491.2011.03447.x
Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liverDiabetic Medicine, 2012, 29(2), 220-226. DOI: 10.1111/j.1464-5491.2011.03427.x
Evaluating the cost-effectiveness of reduced mild hypoglycaemia in subjects with Type 1 diabetes treated with insulin detemir or NPH insulin in Denmark, Sweden, Finland and the NetherlandsDiabetic Medicine, 2012, 29(3), 303-312. DOI: 10.1111/j.1464-5491.2011.03461.x
Evaluation of placental growth factor and soluble Fms-like tyrosine kinase 1 as predictors of all-cause and cardiovascular mortality in patients with Type 1 diabetes with and without diabetic nephropathyDiabetic Medicine, 2012, 29(3), 337-344. DOI: 10.1111/j.1464-5491.2011.03482.x
Alcohol-associated risks for young adults with Type 1 diabetes: a narrative reviewDiabetic Medicine, 2012, 29(4), 434-440. DOI: 10.1111/j.1464-5491.2012.03579.x
Increased serum concentrations of adhesion molecules but not of chemokines in patients with Type 2 diabetes compared with patients with Type 1 diabetes and latent autoimmune diabetes in adult age: Action LADA 5Diabetic Medicine, 2012, 29(4), 470-478. DOI: 10.1111/j.1464-5491.2011.03546.x
Transitions in care: support group for young adults with Type 1 diabetesDiabetic Medicine, 2012, 29(4), 522-525. DOI: 10.1111/j.1464-5491.2011.03537.x
Re-examining a measure of diabetes-related burden in parents of young people with Type 1 diabetes: the Problem Areas in Diabetes Survey - Parent Revised version (PAID-PR)Diabetic Medicine, 2012, 29(4), 526-530. DOI: 10.1111/j.1464-5491.2011.03434.x
Hypoglycaemia during pregnancy in women with Type 1 diabetesDiabetic Medicine, 2012, 29(5), 558-566. DOI: 10.1111/j.1464-5491.2012.03604.x
Poor numeracy skills are associated with glycaemic control in Type 1 diabetesDiabetic Medicine, 2012, 29(5), 662-669. DOI: 10.1111/j.1464-5491.2011.03466.x
Dose Adjustment for Normal Eating (DAFNE) in routine clinical practice: who benefits?Diabetic Medicine, 2012, 29(5), 670-676. DOI: 10.1111/j.1464-5491.2011.03479.x
Working with young adults with Type 1 diabetes: Views of a multidisciplinary care team and implications for service deliveryDiabetic Medicine, 2012, 29(5), 677-681. DOI: 10.1111/j.1464-5491.2012.03601.x
Improved health status with insulin degludec compared with insulin glargine in people with Type 1 diabetesDiabetic Medicine, 2012, 29(6), 716-720. DOI: 10.1111/j.1464-5491.2011.03547.x
Association between age, IL-10, IFNγ, stimulated C-peptide and disease progression in children with newly diagnosed Type 1 diabetesDiabetic Medicine, 2012, 29(6), 734-741. DOI: 10.1111/j.1464-5491.2011.03544.x
Glycaemic control and weight 7 years after Dose Adjustment For Normal Eating (DAFNE) structured education in Type 1 diabetesDiabetic Medicine, 2012, 29(6), 807-812. DOI: 10.1111/j.1464-5491.2011.03525.x
Type 1 diabetes and measles, mumps and rubella childhood infections within the Italian Insulin-dependent Diabetes RegistryDiabetic Medicine, 2012, 29(6), 761-766. DOI: 10.1111/j.1464-5491.2011.03529.x
Metabolic regulation during constant moderate physical exertion in extreme conditions in Type 1 diabetesDiabetic Medicine, 2012, 29(6), 822-826. DOI: 10.1111/j.1464-5491.2011.03453.x
Contemporary rates of severe hypoglycaemia in youth with Type 1 diabetes: variability by insulin regimenDiabetic Medicine, 2012, 29(7), 926-932. DOI: 10.1111/j.1464-5491.2012.03646.x
Arterial stiffness and endothelial dysfunction independently and synergistically predict cardiovascular and renal outcome in patients with type 1 diabetesDiabetic Medicine, 2012, 29(8), 990-994. DOI: 10.1111/j.1464-5491.2012.03633.x
The effect of rising vs. falling glucose level on amperometric glucose sensor lag and accuracy in Type 1 diabetesDiabetic Medicine, 2012, 29(8), 1067-1073. DOI: 10.1111/j.1464-5491.2011.03545.x
Experiences of using blood glucose targets when following an intensive insulin regimen: a qualitative longitudinal investigation involving patients with Type 1 diabetesDiabetic Medicine, 2012, 29(8), 1079-1084. DOI: 10.1111/j.1464-5491.2012.03670.x
Temporal changes in the diagnosis of type 1 diabetes by diabetic ketoacidosis in Brazil: A nationwide surveyDiabetic Medicine, 2012, 29(9), 1142-1147. DOI: 10.1111/j.1464-5491.2012.03590.x
Does severe hypoglycaemia influence microvascular complications in Type 1 diabetes? An analysis of the Diabetes Control and Complications Trial databaseDiabetic Medicine, 2012, 29(9), 1195-1198. DOI: 10.1111/j.1464-5491.2012.03612.x
Number and sex ratio of children and impact of parental diabetes in individuals with Type 1 diabetesDiabetic Medicine, 2012, 29(10), 1268-1271. DOI: 10.1111/j.1464-5491.2012.03618.x
Type 1 diabetes in pre-school children - long-term metabolic control, associated autoimmunity and complicationsDiabetic Medicine, 2012, 29(10), 1291-1296. DOI: 10.1111/j.1464-5491.2012.03682.x
Facilitating children's contributions in clinic? Findings from an in-depth qualitative study with children with Type 1 diabetesDiabetic Medicine, 2012, 29(10), 1303-1310. DOI: 10.1111/j.1464-5491.2012.03714.x
Setting research priorities for Type 1 diabetesDiabetic Medicine, 2012, 29(10), 1321-1326. DOI: 10.1111/j.1464-5491.2012.03755.x
Femoral-gluteal adiposity is not associated with insulin sensitivity in Type 1 diabetesDiabetic Medicine, 2012, 29(11), 1407-1411. DOI: 10.1111/j.1464-5491.2012.03728.x
Prevalence of ketoacidosis at diagnosis of childhood onset Type 1 diabetes in Wales from 1991 to 2009 and effect of a publicity campaignDiabetic Medicine, 2012, 29(12), 1506-1509. DOI: 10.1111/j.1464-5491.2012.03638.x
The risk of proliferative retinopathy in siblings with Type 1 diabetesDiabetic Medicine, 2012, 29(12), 1567-1573. DOI: 10.1111/j.1464-5491.2012.03768.x
Type 1 diabetes from bench to bedside; a dedication to George EisenbarthDiabetic Medicine, 2013, 30(2), 133-133. DOI: 10.1111/dme.12101
The multiple origins of Type 1 diabetesDiabetic Medicine, 2013, 30(2), 135-146. DOI: 10.1111/dme.12081
Immunological pathways to β-cell damage in Type 1 diabetesDiabetic Medicine, 2013, 30(2), 147-154. DOI: 10.1111/dme.12085
The environment and the origins of islet autoimmunity and Type 1 diabetesDiabetic Medicine, 2013, 30(2), 155-160. DOI: 10.1111/dme.12099
Primary and secondary prevention of Type 1 diabetesDiabetic Medicine, 2013, 30(2), 161-169. DOI: 10.1111/dme.12100
Potential role of non-insulin adjunct therapy in Type 1 diabetesDiabetic Medicine, 2013, 30(2), 179-188. DOI: 10.1111/j.1464-5491.2012.03744.x
Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysisDiabetic Medicine, 2013, 30(2), 189-198. DOI: 10.1111/j.1464-5491.2012.03771.x
Prevalence of depression among young people with Type 1 diabetes: a systematic reviewDiabetic Medicine, 2013, 30(2), 199-208. DOI: 10.1111/j.1464-5491.2012.03721.x
Self-treating hypoglycaemia: a longitudinal qualitative investigation of the experiences and views of people with Type 1 diabetesDiabetic Medicine, 2013, 30(2), 209-215. DOI: 10.1111/dme.12007
Insulin analogues in children with Type 1 diabetes: a 52-week randomized clinical trialDiabetic Medicine, 2013, 30(2), 216-225. DOI: 10.1111/dme.12041
The impact of blood glucose and HbA1c goals on glycaemic control in children and adolescents with Type 1 diabetesDiabetic Medicine, 2013, 30(3), 333-337. DOI: 10.1111/dme.12083
The effect of insulin intensification in children and young persons with Type 1 diabetes differs in relation to ethnic group; a prospective observational studyDiabetic Medicine, 2013, 30(4), 495-501. DOI: 10.1111/dme.12022
Urinary sulphate excretion and progression of diabetic nephropathy in Type 1 diabetesDiabetic Medicine, 2013, 30(5), 563-566. DOI: 10.1111/dme.12131
Characterizing the transition from paediatric to adult care among emerging adults with Type 1 diabetesDiabetic Medicine, 2013, 30(5), 610-615. DOI: 10.1111/dme.12067
Clinical and socio-demographic factors associated with diabetic ketoacidosis hospitalization in adults with Type 1 diabetesDiabetic Medicine, 2013, 30(5), 567-573. DOI: 10.1111/dme.12127
HLA class II gene associations in African American Type 1 diabetes reveal a protective HLA-DRB1*03 haplotypeDiabetic Medicine, 2013, 30(6), 710-716. DOI: 10.1111/dme.12148
Type 1 diabetes structured education: what are the core self-management behaviours?Diabetic Medicine, 2013, 30(6), 724-730. DOI: 10.1111/dme.12164
Blood β-hydroxybutyrate vs. urine acetoacetate testing for the prevention and management of ketoacidosis in Type 1 diabetes: a systematic reviewDiabetic Medicine, 2013, 30(7), 818-824. DOI: 10.1111/dme.12136
Vitamin D levels during and after resolution of ketoacidosis in children with new onset Type 1 diabetesDiabetic Medicine, 2013, 30(7), 829-834. DOI: 10.1111/dme.12200
Compromised quality of life in patients with both Type 1 diabetes mellitus and coeliac diseaseDiabetic Medicine, 2013, 30(7), 835-839. DOI: 10.1111/dme.12205
Serological testing for coeliac disease in Type 1 diabetes mellitus: is immunoglobulin A level measurement necessary?Diabetic Medicine, 2013, 30(7), 840-845. DOI: 10.1111/dme.12163
Blood pressure levels but not hypertensive complications have increased in Type 1 diabetes pregnancies during 1989-2010Diabetic Medicine, 2013, 30(9), 1087-1093. DOI: 10.1111/dme.12224
Hypoglycaemia, fear of hypoglycaemia and quality of life in children with Type 1 diabetes and their parentsDiabetic Medicine, 2013, 30(9), 1126-1131. DOI: 10.1111/dme.12247
Diabetes distress in Type 1 diabetes-a new measurement fit for purposeDiabetic Medicine, 2013, 30(9), 1132-1139. DOI: 10.1111/dme.12241
Disclosure of psychosocial stressors affecting diabetes care among uninsured young adults with Type 1 diabetesDiabetic Medicine, 2013, 30(9), 1140-1144. DOI: 10.1111/dme.12248
Vitamin D in youth with Type 1 diabetes: prevalence of insufficiency and association with insulin resistance in the SEARCH Nutrition Ancillary StudyDiabetic Medicine, 2013, 30(11), 1324-1332. DOI: 10.1111/dme.12297
Concordance of retinopathy and nephropathy over time in Type 1 diabetes: an analysis of data from the Diabetes Control and Complications TrialDiabetic Medicine, 2013, 30(11), 1333-1341. DOI: 10.1111/dme.12296
Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescentsDiabetic Medicine, 2013, 30(11), 1360-1366. DOI: 10.1111/dme.12252
Real-time continuous glucose monitoring during labour and delivery in women with Type 1 diabetes - observations from a randomized controlled trialDiabetic Medicine, 2013, 30(11), 1374-1381. DOI: 10.1111/dme.12246
Paediatric estimated average glucose in children with Type 1 diabetesDiabetic Medicine, 2014, 31(1), 36-39. DOI: 10.1111/dme.12285
Impact of continuous glucose monitoring on diabetes management and marital relationships of adults with Type 1 diabetes and their spouses: a qualitative studyDiabetic Medicine, 2014, 31(1), 47-54. DOI: 10.1111/dme.12276
Diabetes-Oriented Learning Family Intervention (DOLFIN): a feasibility study evaluating an intervention for carers of young persons with Type 1 diabetesDiabetic Medicine, 2014, 31(1), 55-60. DOI: 10.1111/dme.12333
Developing a hierarchy of needs for Type 1 diabetesDiabetic Medicine, 2014, 31(1), 61-67. DOI: 10.1111/dme.12284
Patients with Type 1 diabetes consuming alcoholic spirits have an increased risk of microvascular complicationsDiabetic Medicine, 2014, 31(2), 156-164. DOI: 10.1111/dme.12307
The dynamic changes of zinc transporter 8 autoantibodies in Czech children from the onset of Type 1 diabetes mellitusDiabetic Medicine, 2014, 31(2), 165-171. DOI: 10.1111/dme.12308
A novel single nucleotide polymorphism in the protein tyrosine phosphatase N22 gene (PTPN22) is associated with Type 1 diabetes in a Chinese populationDiabetic Medicine, 2014, 31(2), 219-226. DOI: 10.1111/dme.12331
Medical and psychological outcomes for young adults with Type 1 diabetes: no improvement despite recent advances in diabetes careDiabetic Medicine, 2014, 31(2), 227-231. DOI: 10.1111/dme.12305
Urinary type IV collagen as a predictor for the incidence of microalbuminuria in young patients with Type 1 diabetesDiabetic Medicine, 2014, 31(2), 213-218. DOI: 10.1111/dme.12317
Real-time continuous glucose monitoring as a tool to prevent severe hypoglycaemia in selected pregnant women with Type 1 diabetes - an observational studyDiabetic Medicine, 2014, 31(3), 352-356. DOI: 10.1111/dme.12383
Epidemiology of childhood Type 1 diabetes in Taiwan, 2003 to 2008Diabetic Medicine, 2014, 31(6), 666-673. DOI: 10.1111/dme.12407
Plateau of adiposity in Australian children diagnosed with Type 1 diabetes: a 20-year studyDiabetic Medicine, 2014, 31(6), 686-690. DOI: 10.1111/dme.12402
Use of clinical targets in diabetes patient education: qualitative analysis of the expectations and impact of a structured self-management programme in Type 1 diabetesDiabetic Medicine, 2014, 31(6), 733-738. DOI: 10.1111/dme.12401
Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with Type 1 diabetesDiabetic Medicine, 2014, 31(7), 847-853. DOI: 10.1111/dme.12441
Effects of advanced carbohydrate counting in patients with Type 1 diabetes: a systematic reviewDiabetic Medicine, 2014, 31(8), 886-896. DOI: 10.1111/dme.12446
Reductions in resistance exercise-induced hyperglycaemic episodes are associated with circulating interleukin-6 in Type 1 diabetesDiabetic Medicine, 2014, 31(8), 1009-1013. DOI: 10.1111/dme.12462