Gender gaps in type 1 diabetes care

Area of Science:

• Endocrinology and Metabolism
• Public Health
• Gender Studies in Medicine

Background:

• Diabetes mellitus presents a significant global health challenge.
• Women with diabetes experience higher mortality and vascular event risks than men.
• Gender inequalities in diabetes care may contribute to these disparities, particularly in type 1 diabetes.

Purpose of the Study:

• To evaluate gender-based differences in outpatient type 1 diabetes care.
• To specifically assess disparities in diagnostic processes and patient outcomes.
• To investigate potential causes of gender inequalities in diabetes management.

Main Methods:

• A cross-sectional cohort study of adult type 1 diabetes patients (2016-2021) from the Dutch Pediatric and Adult Registry of Diabetes (DPARD).
• Analysis of process measurements (physical exams, lab tests) adjusted for age and BMI.
• Evaluation of gender differences in eGFR, BMI, blood pressure, LDL-cholesterol, HbA1c targets, and cardiovascular risk scores (SCORE).

Main Results:

• Men had higher odds of achieving weight control (17%) but lower odds of meeting blood pressure targets (23%) compared to women.
• Gender-skewed cardiovascular mortality risk scores were observed.
• No gender differences in process measurements indicated healthcare professional bias was not the primary driver.

Conclusions:

• Gender equality is present in the diagnostic phase of type 1 diabetes care.
• Significant differences in weight control, blood pressure management, and cardiovascular risk persist between sexes.
• Multifactorial causes likely underlie these disparities, with interhospital variations in HbA1c control suggesting areas for targeted improvement in Dutch diabetes care.