There are inequalities in approaches to cardiovascular disease in type 2 diabetes.

Among patients with type 2 diabetes, cardiovascular disease (CVD) is the most common cause of morbidity and mortality. Early detection and effective treatment of type 2 diabetes through regular medical check-ups and medication when needed, as well as education on self-care and healthy lifestyle habits, can prevent or delay worsening of the disease and the occurrence of serious CVD complications and associated health care costs. However, a new study European Journal of Public Health highlights the disparity in approach to cardiovascular health in type 2 diabetes. In particular, the paper concludes that there are socioeconomic disparities in cardiovascular outcomes among patients with type 2 diabetes, as well as their magnitude in terms of educational attainment. depends on gender, more pronounced in women. All this suggests the need to take them into account when developing strategies for individual prevention and primary management.

Monitoring in Navarre

To reach this conclusion, a population-based cohort from the southern European region, comprising 24,650 patients with type 2 diabetes, was followed for five years. Specifically, the patients included in this retrospective population-based study were residents of the autonomous region of Navarre…, in northern Spain. In this region, citizens have free access to health care from the Navarre-Osazunbidea Regional Health Service, which is part of the Spanish National Health System. It should be noted that in 2021, 0.24 percent of the Navarre population had exclusively private health insurance. Sex-specific associations between subjects’ socioeconomic status (SES) indicators and the first incident cardiovascular event were modeled using multivariate Fine-Gray competing risks assessment. Coronary heart disease (CHD) and stroke were considered secondary outcomes.

Comparison of men and women

The primary endpoint was defined as the first fatal or nonfatal cardiovascular event during 5 years of follow-up. In addition, two secondary endpoints were taken into account: coronary heart disease and stroke. Thus, it turned out that compared to men, women were five years older and were more likely to be physically inactive. However, you are less likely to be a smoker or have other underlying health conditions. The proportion of women with no formal education or in the €18,000 income category was 12 percent and 23 percent higher than men, respectively. The proportion of immigrants was the same for both sexes, but the continent of origin was slightly different. Baseline characteristics of the entire cohort and stratification by sex according to education level, income, and immigrant status were also described.

Possible explanations

In addition to these findings, the researchers offer possible explanations for these findings. In particular, they suggest that the slightly sex-specific effects observed for different SES indicators on coronary heart disease or stroke in our study may be due to differences between men and women in hormonal profiles or lifestyle factors. The distribution of unknown risk factors for each disease or the response to stress may also be influential. They also point to other environmental factors that may be more closely associated with some specific outcomes and may be better captured by one indicator than another. The finding of a greater effect of income observed in women compared to men on coronary heart disease may be due to an intensification of the pathway linking financial hardship and psychological stress to specific coronary heart disease events in women, as well as possible deficiencies in diagnosis, treatment, and prognosis. coronary heart disease in women, which may be more related to income than education.

Final results

In conclusion, this population-based study found gender-based SES inequalities in CVD risk among patients with type 2 diabetes, which were greater among women than men when adjusted for educational attainment. The researchers therefore conclude that incorporating gender-specific SES indicators to identify patients at high risk of CVD and to develop personalized prevention and treatment strategies is likely to have a direct positive impact on diabetes-related morbidity and mortality.

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