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J Diabetes Res. 2013;2013:575814. doi: 10.1155/2013/575814. Epub 2013 Mar 31.

Sex disparities in diabetes process of care measures and self-care in high-risk patients.

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1
Division of Nephrology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA ; Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA ; Kidney Research Institute, 325 9th Avenue, P. O. Box 359606, Seattle, WA 98104, USA.

Abstract

Patients with chronic diabetic complications experience high morbidity and mortality. Sex disparities in modifiable factors such as processes of care or self-care activities have not been explored in detail, particularly in these high-risk patients. Sex differences in processes of care and self-care activities were assessed in a cross-sectional analysis of the Pathways Study, an observational cohort of primary care diabetic patients from a managed care organization (N = 4,839). Compared to men, women had decreased odds of dyslipidemia screening (adjusted odds ratio (AOR) 0.73, 95% CI 0.62-0.85), reaching low-density lipoprotein goal (AOR 0.70, 95% CI 0.58-0.86), and statin use (AOR 0.69, 95% CI 0.58-0.81); women had 19% greater odds of reaching hemoglobin A1c <7% (95% CI 1.02-1.41). There were no sex differences in hemoglobin A1c testing, microalbuminuria screening, or angiotensin-converting enzyme inhibitor use. Women were less likely to report regular exercise but had better adherence to healthy diet, glucose monitoring, and self-foot examination compared to men. Patterns of sex differences were consistent in subjects with diabetic complications. Significant sex disparities exist in diabetes process of care measures and self-care, even amongst patients known to have chronic diabetic complications.

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