Effect of gender on treatment outcomes in type 2 diabetes mellitus

J. B. McGill, A. Vlajnic, P. G. Knutsen, C. Recklein, M. Rimler, S. J. Fisher

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Aim: To evaluate the effect of gender on clinical outcomes in people with type 2 diabetes mellitus (T2DM) receiving antidiabetes therapy. Methods: This is a pooled analysis from nine similarly designed phase 3 and 4 randomized, controlled studies evaluating insulin glargine and an active comparator (NPH insulin, insulin lispro, premixed insulin, oral antidiabetes drugs, dietary intervention) in adults with T2DM. Impact of gender on outcomes including HbA1c, fasting plasma glucose (FPG), weight-adjusted insulin dose, and hypoglycemia incidence was evaluated after 24 weeks of treatment. Results: Overall, 1651 male and 1287 female individuals were included; 49.8% and 50.2% were treated with insulin glargine or comparators, respectively. Females receiving insulin glargine were less likely than males to achieve a glycemic target of HbA1c ≤ 7.0% (53. mmol/mol) (54.3% vs 60.8%, respectively, p= 0.0162); there was no difference between females and males receiving comparators (52.7% vs 51.3%, respectively, p= 0.4625). Females had significantly greater reductions in FPG (3.1. mg/dL, p= 0.0458), required significantly higher insulin doses (0.03. IU/kg, p= 0.0071), and had significantly higher annual rates of symptomatic (p< 0.0001), glucose-confirmed (<50 and <70. mg/dL) symptomatic (p= 0.0005 and p< 0.0001), and severe hypoglycemia (p= 0.0020) than males. Conclusions: Females in this analysis had smaller reductions in HbA1c and were less likely to reach glycemic goals despite higher insulin doses and more hypoglycemic events than males. Differences in gender responses to therapy should be considered when individualizing treatment for people with T2DM.

Original languageEnglish
Pages (from-to)167-174
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume102
Issue number3
DOIs
StatePublished - Dec 2013

Bibliographical note

Funding Information:
This study was funded by Sanofi US, Inc . The authors received writing/editorial support in the preparation of this manuscript provided by Katherine Roberts, PhD, of Excerpta Medica, funded by Sanofi US, Inc.

Keywords

  • Gender
  • Glycemic control
  • Hypoglycemia
  • Insulin glargine
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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