Gender Difference in All-Cause and Cardiovascular Mortality Related to Hyperglycemia and Newly Diagnosed Diabetes

AIM/HYPOTHESIS-Diabetic women generally have a greater relative risk of cardiovascular diseases than diabetic men in comparison with non-diabetic women and men. Reasons for this excess risk in diabetic women is still unclear. The aim of this study is to evaluate whether the association between different degrees of hyperglycemia and the risk of all-cause and cardiovascular mortality is different in women and men. 

METHODS-We analyzed baseline glucose concentrations from 14 prospective European cohorts including 8,172 men and 9,407 women aged 30 to 89 years without history of diabetes, with a median follow-up of 8.3 years. Hazards ratios for all-cause and cardiovascular mortality were estimated adjusting for other risk factors. 
RESULTS-The mortality rates for all-cause and cardiovascular diseases were higher in men than in women in normoglycemia, impaired glucose regulation and newly diagnosed diabetes; the largest sex differential for cardiovascular mortality was in normoglycemic people. The hazards ratios for all-cause and cardiovascular mortality were higher in newly diagnosed diabetic women than men compared with normoglycemic women and men, respectively; however, this sex difference was only significant for cardiovascular mortality. For smokers and for subjects with hypertension, hypercholesterolemia or who where overweight, the hazards ratios for cardiovascular mortality in diabetic patients compared with normoglycemic people were also higher in women than in men. 
CONCLUSIONS/INTERPRETATION-Newly diagnosed diabetic women showed higher relative risks for death from cardiovascular disease than diabetic men. Thus a more aggressive control of hyperglycemia as well as of other cardiovascular risk factors might be appropriate in women with asymptomatic hyperglycemia. 
Hu G, The DECODE Study Group. Gender Difference in All-Cause and Cardiovascular Mortality Related to Hyperglycaemia and Newly-Diagnosed Diabetes. Diabetologia. 2003;46:608-617. 
Last Modified: 1/16/2013