|Home | About | Journals | Submit | Contact Us | Français|
Reduced mortality from cardiovascular disease has been a major public health success in industrialised countries, but how has this improvement extended to patients with diabetes? A study of mortality trends across three large US cohorts found that men have benefited more than women over the last three decades.
All cause mortality rates for men with diabetes fell by 43% between 1971 and 2000 (from 42.6 to 24.4 deaths per 1000 persons per year, P=0.03), which is a similar relative fall to that seen in men without diabetes. A reduction in mortality from cardiovascular causes in men with diabetes paralleled this trend (26.4 to 12.8, P=0.06).
Neither the all cause nor the cardiovascular mortality rates fell over the time period for women with diabetes, and the difference between all cause mortality in women with diabetes and without diabetes doubled (from a difference of 8.3 deaths to 18.2 deaths per 1000 persons per year, P=0.04).
The lack of improvement in women is hard to explain. A linked editorial (p 208-10) says evidence indicates women with coronary heart disease and diabetes are less likely to receive appropriate care. It adds, however, that risk factors for cardiovascular disease might be more common, more severe, or more likely to cluster in women with diabetes than in men.men.