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Research article:
Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities
Reference:
Alison K. Wright, Evangelos Kontopantelis, Richard Emsley, Iain Edward Buchan, Mamas A. Mamas, Naveed Sattar, Darren M. Ashcroft, and Martin K. Rutter(2019) Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities. Circulation, doi: 10.1161/CIRCULATIONAHA.118.039100
- Link to article
- Abstract
- Background: With recent changes in UK clinical practice for diabetes care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed. Methods: In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79,985 patients with incident T2DM between 2006-2013 matched to 386,547 patients without diabetes. Sex-stratified Cox models were used to assess cardiovascular risk. Results: Compared to women without T2DM, women with T2DM had a higher cardiovascular event risk (adjusted HR 1.20 [95% CI 1.12-1.28]) with similar corresponding data in men (HR 1.12 [1.06-1.19]) leading to a non-significant higher relative risk in women (risk ratio 1.07 [0.98-1.17]). However, some important sex differences in the management of risk factors were observed. Compared to men with T2DM, women with T2DM were more likely to be obese, hypertensive and have hypercholesterolaemia but were less likely to be prescribed lipid-lowering medication and ACE inhibitors, especially if they had CVD. Conclusions: Compared to men developing T2DM, women with T2DM do not have a significantly higher relative increase in cardiovascular risk, but ongoing sex disparities in prescribing should prompt heightened efforts to improve the standard and equity of diabetes care in women and men.
- Author for correspondence
- Alison Wright
- Email for correspondence
- alison.wright@manchester.ac.uk
Code list: res72: Obesity
21 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 22A5.11 | Read | O/E - obese | diagnostic | res72: Obesity | |||
| 22K5.00 | Read | Body mass index 30+ - obesity | diagnostic | res72: Obesity | |||
| 22K7.00 | Read | Body mass index 40+ - severely obese | diagnostic | res72: Obesity | |||
| 22KC.00 | Read | Obese class I (body mass index 30.0 - 34.9) | diagnostic | res72: Obesity | |||
| 22KD.00 | Read | Obese class II (body mass index 35.0 - 39.9) | diagnostic | res72: Obesity | |||
| 22KE.00 | Read | Obese class III (BMI equal to or greater than 40.0) | diagnostic | res72: Obesity | |||
| 66C4.00 | Read | Has seen dietician - obesity | diagnostic | res72: Obesity | |||
| 66C5.00 | Read | Treatment of obesity changed | diagnostic | res72: Obesity | |||
| 66C6.00 | Read | Treatment of obesity started | diagnostic | res72: Obesity | |||
| 8CV7.00 | Read | Anti-obesity drug therapy commenced | diagnostic | res72: Obesity | |||
| C38..00 | Read | Obesity and other hyperalimentation | diagnostic | res72: Obesity | |||
| C380.00 | Read | Obesity | diagnostic | res72: Obesity | |||
| C380200 | Read | Extreme obesity with alveolar hypoventilation | diagnostic | res72: Obesity | |||
| C380300 | Read | Morbid obesity | diagnostic | res72: Obesity | |||
| C380400 | Read | Central obesity | diagnostic | res72: Obesity | |||
| C380500 | Read | Generalised obesity | diagnostic | res72: Obesity | |||
| C38y011 | Read | Obesity hypoventilation syndrome | diagnostic | res72: Obesity | |||
| C38z000 | Read | Simple obesity NOS | diagnostic | res72: Obesity | |||
| Cyu7.00 | Read | [X]Obesity and other hyperalimentation | diagnostic | res72: Obesity | |||
| Cyu7000 | Read | [X]Other obesity | diagnostic | res72: Obesity | |||
| ZC2CM00 | Read | Dietary advice for obesity | diagnostic | res72: Obesity |
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