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Heart failure associated with diabetes is more common in women than men

With diabetes continuing to grow as a global problem, new data on the impact of disease, especially on risk factors for other conditions, can have a profound impact on clinical practice.

The results of the latest study can do that, because the researchers conducted a global study involving more than 12 million participants and found that the risk of heart failure (HF) associated with diabetes was greater in women than in men.

"It is well known that diabetes puts you at a greater risk of heart failure, but what our study shows for the first time is that women are at far greater risk – for type 1 and type 2 diabetes," said lead researcher Toshiaki Ohkuma, PhD, from the George Institute.

Researchers tried to evaluate whether the relationship between the risk of heart failure in diabetic patients was the same between men and women. The current meta-analysis is a systematic review of population-based studies published between January 1966 and November 2018.

Data includes participants from 10 countries including Australia, the United States, Britain, Italy, China and Taiwan.

To be included, the study should be an observational cohort study and is needed to provide a gender-specific risk ratio (RR) or equivalent. Studies that only report data for one sex, do not adjust age, or do not provide information about the variability of point estimates issued. The investigator identified research through a systematic search in PubMed in November 2018.

From their search, a total of 5991 articles were identified and 760 of them qualified for full text evaluation. A group of 14 articles, all of which provided summary data for sex differences in the relationship between diabetes and the risk of heart failure, were selected for this study.

The 14 articles selected contained 11,925,128 individuals who experienced a total of 249,560 events. In a multivariable analysis, the investigators found that the RR for HF associated with type 1 diabetes was 5.15 (95% CI 3.43, 7.74) in women and 3.47 (2.57, 4.69 ) in men – this is related to the RR ratio of 1.47 (1.44, 1.90).

For type 2 diabetes, RR collected for HF associated with tee dull type was 1.95 in women and 1.74 in men. This corresponds to a combined RRR of 1.09.

"Women are reported to have a prediabetes duration of two years longer than men and an increase in this duration can be associated with a greater risk of heart failure in women," said Sanne Peters, PhD, of the George Institute. "Some of the main concerns are that women are also undergoing therapy for diabetes, not taking the same level of drugs as men and are less likely to receive intensive care."

The study, titled "Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million people," was published in Diabetologia.

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