Pradeepa Rajendra, Shreya Lal, Anjana Ranjit Mohan, Jebarani Saravanan, Venkatesan Ulagamathesan, Kamal Raj Nithyanantham, Swami Onkar C, Mohan Viswanathan
Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India.
Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India.
Healthcare (Basel). 2023 Jun 2;11(11):1634. doi: 10.3390/healthcare11111634.
This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January 2017 and 31 December 2019, and included 72,980 individuals with T2DM, aged ≥ 18 years (age and sex-matched-males-36,490; females-36,490). Anthropometric measurements, blood pressure, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), glycated haemoglobin (HbA1c), lipids, urea, and creatinine were measured. Retinopathy was screened using retinal photography, neuropathy using biothesiometry, nephropathy measuring urinary albumin excretion, peripheral vascular disease (PVD) using Doppler, and coronary artery disease (CAD) based on the history of myocardial infarction and/or drug treatment for CAD and/or electrocardiographic changes. Obesity (73.6% vs. 59.0%) rates were significantly higher in females compared to males. FPG, PPPG, and HbA1c were higher among younger age groups among both sexes, with males having higher values compared to females. However, after the age of 44 years, control of diabetes was worse among females. In addition, only 18.8% of the females achieved glycemic control (HbA1c < 7%) compared to 19.9% in males ( < 0.001). Males had higher prevalence of neuropathy (42.9% vs. 36.9%), retinopathy (36.0% vs. 26.3%), and nephropathy (25.0% vs. 23.3%) compared to females. Males had 1.8- and 1.6-times higher risk of developing CAD and retinopathy compared to females. Hypothyroidism (12.5% vs. 3.5%) and cancers (1.3% vs. 0.6%) were significantly higher in females compared to males. In this large sample of T2DM seen at a chain of private tertiary diabetes centres, females had higher prevalence of metabolic risk factors and poorer diabetes control compared to males, emphasizing the need for better control of diabetes in females. However, males had higher prevalence of neuropathy, retinopathy, nephropathy, and CAD compared to females.
本研究旨在比较在印度一家私立三级糖尿病护理中心就诊的2型糖尿病（T2DM）男性和女性的临床和生化特征以及并发症情况。这是一项回顾性研究，于2017年1月1日至2019年12月31日期间进行，纳入了72980名年龄≥18岁的T2DM患者（年龄和性别匹配——男性36490名；女性36490名）。测量了人体测量指标、血压、空腹血糖（FPG）、餐后血糖（PPPG）、糖化血红蛋白（HbA1c）、血脂、尿素和肌酐。使用视网膜摄影筛查视网膜病变，使用生物感觉测量法筛查神经病变，测量尿白蛋白排泄量筛查肾病，使用多普勒检查筛查外周血管疾病（PVD），并根据心肌梗死病史和/或CAD药物治疗史和/或心电图变化诊断冠状动脉疾病（CAD）。女性肥胖率（73.6%对59.0%）显著高于男性。两性中较年轻年龄组的FPG、PPPG和HbA1c较高，男性的值高于女性。然而，44岁以后，女性的糖尿病控制情况较差。此外，只有18.8%的女性实现了血糖控制（HbA1c<7%），而男性为19.9%（<0.001）。与女性相比，男性神经病变（42.9%对36.9%）、视网膜病变（36.0%对26.3%）和肾病（25.0%对23.3%）的患病率更高。与女性相比，男性患CAD和视网膜病变的风险分别高1.8倍和1.6倍。女性甲状腺功能减退症（12.5%对3.5%）和癌症（1.3%对0.6%）的患病率显著高于男性。在这家私立三级糖尿病中心连锁机构所观察的这一大型T2DM样本中，与男性相比，女性代谢危险因素的患病率更高，糖尿病控制情况更差，这凸显了女性更好地控制糖尿病的必要性。然而，与女性相比，男性神经病变、视网膜病变、肾病和CAD的患病率更高。
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