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Drop in diabetes mortality not seen in women
NEW YORK (Reuters Health) - In the last three decades, all-cause and cardiovascular disease mortality has decreased in men with diabetes, whereas no significant drop occurred in women with the disease, new research shows.
"The improvements seen in men suggest that improvements in diabetes care are working on longevity as well," lead author Dr. Edward W. Gregg, from the Centers for Disease Control and Prevention in Atlanta, said in a statement. "But the finding in women is concerning and means we may need to explore whether different approaches are needed to improve health outcomes for women with diabetes."
The findings, which will be published in the August 7 issue of the Annals of Internal Medicine, stem from an analysis of data from three consecutive, nationally representative cohorts. The study focused on mortality trends from 1971 to 2000 of more than 26,000 adults, including 2,059 with self-reported diabetes.
During the study period, all-cause and cardiovascular disease mortality in diabetic men fell from 42.6 to 24.4 and from 26.4 to 12.8 annual deaths per 1000 persons, respectively. Both trends were similar to what was seen in nondiabetic populations.
In diabetic women, by contrast, no significant drop in all-cause or cardiovascular disease mortality occurred during the study period. Moreover, compared with nondiabetic women, all-cause mortality more than doubled over the 30-year period.
The drop in mortality seen in male diabetics eliminated the gender difference in rates among diabetic adults noted in prior surveys, the authors state.
According to a related editorial, the key to improving mortality in diabetic women is to address the heightened cardiovascular risk seen in this group.
Dr. Nanette K. Wenger, from Grady Memorial Hospital in Atlanta, comments that "we lack an evidence-based comprehensive strategy for improving cardiovascular outcomes in diabetic women."
"Until we do, a prudent clinical approach involves two steps," she continued. "First, recognize that diabetic women are at excess risk of developing coronary heart disease. Second, take an aggressive, guideline-based approach to coronary heart disease risk factor management."
Ann Intern Med 2007.
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