Background: Gender specific differences appear particularly relevant in the overall management and outcome of type 2 diabetes mellitus (T2DM). We determined gender specific differences in cardio-metabolic risk, microvascular, and macrovascular complications in patients with T2DM.
Method: Four hundred T2DM patients matched for age and disease duration were studied. Relevant clinical information, physical examination and laboratory data were analysed.
Results: Of the 400 patients with T2DM, 190 (47.5%) were males and 52.5% were females. The mean age of the study population was 60.6+9.93 years while the mean duration of DM was 7.81+5.76 years. Women had higher prevalence of hypertension (83.3% vs 72.1%) and obesity (34.8% vs 14.7%) than men P<0.05. Mean total cholesterol was significantly higher in women (4.45 mmol/l) than in men (4.08 mmol/l); P=0.001. More women (31.4%) reached target glycaemic goals of HbA1c of <7.0% than men (16.8%). There were no gender differences in microvascular and macrovascular complications (P>0.05) but women were more likely to have moderatesevere retinopathy (P=0.027) while men were more likely to have severe neuropathy (defined as greater than two abnormal tests plus symptoms); P=0.011. Logistic regression analysis showed that the use of antiplatelet drugs was associated with a lower risk of microvascular complication in both men and women while diastolic blood pressure above 80 mmHg doubled the risk in men and tripled it in women (P<0.05). Poor glycaemic control in men and total cholesterol above 5.2 mmol/l in men and women were associated with macrovascular complications. Waist circumference below 80 cm was protective from macrovascular complication in women.
Conclusion: Women with T2DM had worse cardiometabolic risk profile while men achieved therapeutic goals less frequently than women. Complications occurred commonly in both sexes but there was significant male predominance as severity of neuropathy worsened and female predominance as severity of retinopathy increased.