Recent research from authors in the Diabetologigia online journal suggests that women diagnosed with diabetes are at a much greater risk of fatal coronary heart disease (CHD) events when compared to their male counterparts diagnosed with the same condition. To be statistically specific here, women have a 44% greater relative risk of CHD related incidents then men. Given previous research has highlighted that women diagnosed with diabetes are also at 25% greater risk of a stroke compared to men, there is a significant body of evidence suggesting diabetes presents a greater coronary hazard in women than it does in men. As startling as this statistic is, I could quite easily end this article here and be happy with the impact made.
The precise mechanism for this remains uncertain, although findings in the above mentioned meta-analysis will be sure to drive more focused investigations into gender differences and diabetes. One proposed mechanism for this is that metabolic risk markers have to deteriorate to a greater extent in females in order to reach a diagnosed diabetic state. Concurrent to this proposal is the comparison of male/female Body Mass Index (BMI) results upon diagnosis. The results indicated that males were significantly less obese in comparison to newly diagnosed females. Given these important findings, should women and men be prescribed the same intervention, it is logical to suggest some females could in fact be ‘under treated’ and so potentially begins a potential cascade of complications leading to CHD.
So what does this mean for the future? The findings will potentially have pivotal implications for the management of diabetes and CHD prevention. In the near future this research may drive sex specific strategies and screening procedures in pre-diabetic populations. Specifically, women may be prescribed greater screening focus at pre-diabetic stages, with premium importance placed upon follow up interventions compared to their male counterparts.
It is hoped that the application of such focus and sex specific interventions could have a significant and positive impact of the prevention of CHD in females post diabetes diagnosis.
Research Associate, Rescon Ltd
Peters, S., Rachel R. Huxley R., and Woodward, M. (2014). Diabetes as risk factor for incident coronary heart disease in women compared with men: a systematic review and meta-analysis of 64 cohorts including 858,507 individuals and 28,203 coronary events. Diabetologia. DOI 10.1007/s00125-014-3260-6.