Sex Differences in the Occurrence of Major Clinical Events in Elderly
                    People with Type 2 Diabetes Mellitus Followed up in the General
                    Practice

Abdallah Al-Salameh; Sophie Bucher; Bernard Bauduceau; Linda Benattar-Zibi; Gilles Berrut; Philippe Bertin; Emmanuelle Corruble; Nicolas Danchin; Geneviève Derumeaux; Jean Doucet; Bruno Falissard; Françoise Forette; Olivier Hanon; Rissane Ourabah; Florence Pasquier; Michel Pinget; Laurent Becquemont; Virginie Ringa

doi:10.1055/a-0662-5923

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Exp Clin Endocrinol Diabetes 2020; 128(05): 311-318
DOI: 10.1055/a-0662-5923

Article

Sex Differences in the Occurrence of Major Clinical Events in Elderly People with Type 2 Diabetes Mellitus Followed up in the General Practice

Abdallah Al-Salameh

¹Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France

²Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France

,

Sophie Bucher

¹Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France

³General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France

,

Bernard Bauduceau

⁴Endocrinology Department, Begin Hospital, Saint-Mandé, France

,

Linda Benattar-Zibi

⁵Medical Director of ORPEA/CLINEA, Puteaux, France

,

Gilles Berrut

⁶Clinical Gerontology, Nantes University Hospital, Nantes, France

,

Philippe Bertin

⁷Rheumatology Department, Limoges University Hospital, Limoges, France

,

Emmanuelle Corruble

⁸INSERM U 1178, Paris-Sud Faculty of Medicine, Paris-Sud University, Psychiatry Department, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France

,

Nicolas Danchin

⁹Cardiology department, Hôpital Européen Georges Pompidou, Paris, France

,

Geneviève Derumeaux

¹⁰Cardiovascular Functional Exploration, Louis-Pradel Hospital, Hospices Civils de Lyon, Bron, France

,

Jean Doucet

¹¹Internal Medicine, Geriatrics and Therapeutics, Saint-Julien University Hospital, Rouen University, Rouen, France

,

Bruno Falissard

¹Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France

,

Françoise Forette

¹²Paris Descartes University, National Foundation of Gerontology, Paris, France

,

Olivier Hanon

¹³Paris Descartes University, EA 4468, Assistance Publique-Hôpitaux de Paris, Broca Hospital, Geriatrics Department, Paris, France

,

Rissane Ourabah

³General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France

,

Florence Pasquier

¹⁴University of Lille Nord de France, UDSL, EA 1046, Lille University Hospital, Lille, France

,

Michel Pinget

¹⁵Endocrinology, Diabetes and Nutrition-Related Diseases, Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France

,

Laurent Becquemont

¹Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France

²Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France

¹⁶University Paris-Sud Faculty of Medicine, Pharmacology Department and Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France

,

Virginie Ringa

¹Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France

› Institutsangaben

Abstract

Aims The main aim of the present work was to assess if sex influences the occurrence of major clinical events in elderly people with type 2 diabetes followed up in the primary care.

Methods 983 subjects aged ≥65years with type 2 diabetes were included by 213 general practitioners and followed up prospectively for three years. Major clinical events were recorded every six month. The first endpoint was a composite of all-cause death and major vascular events (acute coronary syndrome, non-fatal stroke or transient ischemic attack, or revascularization for peripheral artery disease). The second endpoint was all-cause hospitalization. The occurrence of each endpoint was analyzed in order to estimate the role of sex and determine other predictors of major clinical events.

Results At baseline, women were older than men but they had a lower prevalence of coexisting diseases (cardiovascular disease and cancer) and equivalent diabetes control (Glycated hemoglobin A1C: 6.9%±0.9 vs. 7.0%±1.1). Over the follow-up period, women were at lower risk to develop the composite endpoint (HR 0.60, 95% CI 0.40-0.91, p=0.016) and the hospitalization endpoint (OR 0.71, 95% CI 0.52-0.96, p=0.029). Coexisting diseases, functional ability and concomitant medications emerged as significant predictors of both endpoints.

Conclusions Elderly women with well-controlled type 2 diabetes were less likely to experience major clinical events than their male counterparts. More studies are needed to determine the reasons for the higher hospitalization rate in men.

Key words

Type 2 Diabetes Mellitus - sex- and gender-related differences - elderly - mortality - cardiovascular disease - hospitalization - primary care

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Referenzen

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