Women with diabetes, particularly those under 55 years of age, have a disproportionate burden of obesity and hypertension at diagnosis compared to men, which may explain their loss of the typical female advantage in cardiovascular disease risk.
BACKGROUND: The relative risk of cardiovascular disease (CVD) associated with diabetes is greater for women than men, and diabetic women did not experience temporal declines in CVD mortality observed for the general population and diabetic men. OBJECTIVE: To examine sex differences in CVD risk factors for persons with diabetes over time. DESIGN: Population-based historical cohort study. METHODS: The provider-linked medical records of all Rochester, MN, residents assigned a clinical diagnosis of diabetes were reviewed to confirm case status and assign diagnosis date. Data on fasting glucose, obesity, persistent proteinuria, smoking, hypertension, and dyslipidemia were obtained at diagnosis for confirmed incidence cases. RESULTS: There were 1330 diabetes cases 1970- 1989. Compared to men, women at diagnosis were older and more likely hypertensive, had similar levels of fasting glucose and persistent proteinuria, and less likely to smoke. Among persons diagnosed at younger ages, women were more likely than men to be obese. Comparison with published data for the Rochester population revealed the excess obesity and hypertension associated with diabetes were highest for women < age 55 y. Temporal trends in CVD risk factors did not differ between diabetic men and women.
C. L. Leibson (1999) studied this question.