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Exp Clin Endocrinol Diabetes 2020; 128(05): 311-318
DOI: 10.1055/a-0662-5923
Article
© Georg Thieme Verlag KG Stuttgart · New York

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
1   Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
2   Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France
,
Sophie Bucher
1   Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
3   General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
,
Bernard Bauduceau
4   Endocrinology Department, Begin Hospital, Saint-Mandé, France
,
Linda Benattar-Zibi
5   Medical Director of ORPEA/CLINEA, Puteaux, France
,
Gilles Berrut
6   Clinical Gerontology, Nantes University Hospital, Nantes, France
,
Philippe Bertin
7   Rheumatology Department, Limoges University Hospital, Limoges, France
,
Emmanuelle Corruble
8   INSERM 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
9   Cardiology department, Hôpital Européen Georges Pompidou, Paris, France
,
Geneviève Derumeaux
10   Cardiovascular Functional Exploration, Louis-Pradel Hospital, Hospices Civils de Lyon, Bron, France
,
Jean Doucet
11   Internal Medicine, Geriatrics and Therapeutics, Saint-Julien University Hospital, Rouen University, Rouen, France
,
Bruno Falissard
1   Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
,
Françoise Forette
12   Paris Descartes University, National Foundation of Gerontology, Paris, France
,
Olivier Hanon
13   Paris Descartes University, EA 4468, Assistance Publique-Hôpitaux de Paris, Broca Hospital, Geriatrics Department, Paris, France
,
Rissane Ourabah
3   General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France
,
Florence Pasquier
14   University of Lille Nord de France, UDSL, EA 1046, Lille University Hospital, Lille, France
,
Michel Pinget
15   Endocrinology, 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
1   Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
2   Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Centre de Recherche Clinique Paris-Sud, Le Kremlin-Bicêtre, France
16   University Paris-Sud Faculty of Medicine, Pharmacology Department and Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
,
Virginie Ringa
1   Centre de recherche en Epidémiologie et Santé des Populations (CESP), Faculté de Médecine – Université Paris-Sud, INSERM, Université Paris-Saclay, 94805, Villejuif, France
› Author Affiliations
Further Information

Publication History

received 26 March 2018
revised 08 July 2018

accepted 23 July 2018

Publication Date:
22 August 2018 (online)

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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

Supplementary Material

 

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