Gender Matters: On Recurrence Risk of Cardiovascular Complications for Type 2 Diabetes Subjects

Background Previous reports suggest that, despite men facing higher absolute risks of cardiovascular complications, women with type 2 diabetes (T2DM) experience greater relative risks of cardiovascular events. Studies prior to 2000 indicated a significant impact of cardiovascular disease (CVD) in women with diabetes, but recent research shows inconsistent results. The uncertainty persists on whether sex differences in the impact of diabetes on CVD and mortality exist, and if so, whether they depend on age or other cardiovascular risk factors. Methods This study analyzed data from Italian Diabetes Outpatient clinics (2005–2018) for more than 300,000 patients. We leveraged sequential data mining techniques such as the incremental risk score (lift score) to investigate whether T2DM is associated with a higher risk of recurrent macrovascular events in women compared to men. We used Cohen's d to compare risk factors in men and women and Chi-square test to compare the number of treatments prescribed. Results The incremental risk for women was significantly higher (20% on average) as compared to men for most of the analyzed sequence of major cardiovascular events. A deep analysis of risk factors and therapeutic treatment did not provide a clear explanation for this risk difference . Conclusions In this nationwide study, we observed that although men have higher absolute rates of first-occurrence of macro vascular complications, the relative risk of recurrent cardiovascular complications are higher in women across all ages. The study suggests that the treatment and care for cardiovascular complications in diabetic patients should reflect the differences in the risk for subsequent major cardiovascular events in men and women.