DIABETOLOGIA

A new study presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain (16-20 Sept) shows that men and women experience different comorbidities (other diseases at the same time) as having diabetes or prediabetes, as well as an unexpectedly high rate of prediabetes among children aged 6-10 years.

The study, by Dr Alina Ofenheimer, Sigmund Freud University, Medical School, Vienna, Austria and colleagues, analysed the sex and gender differences in the prevalence of co-morbidities in subjects with prediabetes and diabetes, as well as determining the prevalence of prediabetes and diabetes in the study population.

A number of additional disease processes (comorbidities) are known to occur alongside prediabetes and/or diabetes including congestive heart failure, high blood pressure, cardiac arrhythmia (abnormal heart rate), osteoporosis (weaker bones), kidney dysfunction, and even severe anxiety and depression. Gender may affect the incidence of these comorbidities through differences in biology as well as differences in lifestyle and behaviour.

The authors conducted an observational population-based cohort study of 11,014 subjects aged 6 to 80 years who underwent a detailed examination. This included taking blood samples, measuring ankle-brachial index, performing an electrocardiogram (ECG), assessing body composition using a dual energy X-ray absorptiometry (DEXA) scan, and an interviewer-administered questionnaire. Prediabetes and diabetes were defined by one or all of fasting plasma glucose levels (prediabetes: 100-125mg/dl, diabetes: 126mg/dl or higher), glycated haemoglobin (HbA1c) levels (prediabetes: 5.7-<6.5%, diabetes: 6.5% or higher), and/or if the subject was taking glucose-lowering drugs.

The team found that for the study population as a whole, the prevalence of prediabetes was 20.2% (male 23.6%; female 17.1%) and 5.4% for diabetes (male 7.3%; female 3.7%). Prediabetes occurrence varied from 4.4% in male subjects age 6-<10 years, to 40.4% in those aged 70+ years, while in females it ranged from 4.8% to 42.3% in those same age groups. (For detailed graph, rates of diabetes and prediabetes and comorbidities, see notes to editors and also email [email protected] as some figures do not copy to Eurekalert).

The authors say: “Angina, heart attack and calcification (hardening) of the arteries were more prevalent in diabetic men than diabetic women, as well as mild anxiety and reduced cognitive processing speed. Similar to the comorbidity profile of prediabetic females, women with diabetes had a higher prevalence of irregular heartbeat (arrhythmia), and elevated signs of systemic inflammation compared with diabetic men. Prediabetic women also showed a higher prevalence of osteoporosis and depression compared with prediabetic men.”

They add: “The unexpected 4.6% prevalence of prediabetes in children aged 6-10 underscores the need for population-based studies across all ages and the importance of starting diabetes prevention efforts at a young age, through a healthy lifestyle and diet for all, including children.”