U.S. Women Lagging in Diabetes Care, Study Suggests

Death rates are down for men but up for women

MONDAY, June 18, 2007 (HealthDay News) -- In a finding that partly challenges the conventional wisdom that women live longer than men, a new study suggests that the medical advances of the last few decades against diabetes haven't benefited women.

Researchers found that the death rates of diabetic men dropped in recent decades, while those of diabetic women increased. It's not clear why the discrepancy exists.

"I do not have a clue," said Dr. Larry Deeb, president of medicine and science for the American Diabetes Association (ADA), when asked why women are falling behind. "But I do know that it argues that something we're doing isn't right. If you're a woman, and you have diabetes, it may be we're not aggressive enough about taking care of you."

In the new study, researchers led by Edward Gregg, an epidemiologist with the U.S. Centers for Disease Control and Prevention, examined health surveys spanning 1971 to 2000 to determine the death rates of Americans with diabetes. The researchers looked at about 27,000 people.

They found that among diabetic men, the death rate from all causes dipped from 42.6 to 24.4 deaths per 1,000 persons between the two time periods.

Among men, "their mortality rates have declined," Gregg said, "and they've kept pace with their non-diabetic counterparts."

But among diabetic women, the death rate actually rose from 18.4 to 25.9 per 1,000, even as the life span of non-diabetic women grew longer.

Death rates from cardiovascular disease, in particular, stayed steady among women with diabetes while dropping among diabetic men.

The researchers reported their findings in the June 18 online edition of the Annals of Internal Medicine.

Why are women with diabetes at such high risk? "We can speculate on a few possibilities, that risk factors for things such as heart disease haven't declined as much among women as in men," Gregg said. "Another possibility is that women haven't gotten as aggressive or comprehensive treatment as men have over the years."

The ADA's Deeb, who's familiar with the study findings, said the research appears to be sound. "I don't think we can discount it," he said. "I think it's real."

An estimated 9.7 million American women have diabetes, and almost one-third of them don't know it. Women with diabetes are more likely to have a heart attack, and at a younger age, than women without diabetes, according to the ADA.

Diabetes is at least two to four times more common among black, Hispanic, American Indian, and Asian/Pacific Islander women than white women. The risk for the disease increases with age. Given the increasing life span of women and the rapid growth of minority populations, the number of women in the United States at risk for diabetes is increasing, the ADA said.

Meanwhile, a new U.S. study released Monday said that women are now about as likely as men to get recommended screening tests and treatments to manage their diabetes.

According to the latest News and Numbers from the federal Agency for Healthcare Research and Quality, for Americans age 40 and over with diabetes:

  • The percentage of women who report being given three key recommended exams for diabetes -- blood sugar, retinal and foot -- increased from 37 percent in 2000 to 47 percent in 2003. During the same period, the percentage of men who reported receiving these exams rose only 3 percent from 46 percent to 49 percent.
  • The proportion of women whose blood sugar level was optimal increased from 38 percent for the period 1988 to 1994 to 47 percent for 1999 to 2002. In contrast, the proportion of men with optimal blood sugar level fell from 44 percent to 43 percent during the period.
  • In spite of the narrowing disparities between the genders, less than 60 percent of Americans, as a whole, receive optimal care for their diabetes.

More information

To learn more about women and diabetes, visit the U.S. Food and Drug Administration.

SOURCES: Edward Gregg, Ph.D., epidemiologist, Division of Diabetes Translation, U.S. Centers for Disease Control and Prevention, Atlanta; Larry Deeb, M.D., president of medicine and science, American Diabetes Association, Tallahassee, Fla.; June 18, 2007, Annals of Internal Medicine, online; June 18, 2007, News and Numbers, U.S. Agency for Healthcare Research and Quality, Rockville, Md.
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