Steep Drop In Death Among Diabetic Men

The death rate for men with diabetes has dropped sharply in recent decades, but similar declines have not been seen in women with the disease, a new analysis from the Centers for Disease Control shows.

CDC researchers examined data from a national health database to get a clearer picture of mortality trends among people with diabetes between 1970 and 2000.

While deaths from heart disease and other causes declined steadily during the period for men and women who did not have diabetes and for men with the disease, the death rate among female diabetes patients did not decline at all.

Deaths from all causes among men with diabetes fell by 43 percent during the 30-year period. Deaths due to cardiovascular causes were cut in half among men with diabetes during the period, from 26 deaths to about 13 deaths annually for every 1,000 men with the disease.

Heart attack, stroke, and other cardiovascular events are the leading causes of death among people with diabetes.

"The encouraging findings in men tell us that diabetics can benefit as much as the general population from treatments and other interventions aimed at reducing cardiovascular risk," CDC epidemiologist Edward W. Gregg, PhD, tells WebMD. "The challenge is to understand why women with diabetes don't seem to be benefiting in the same way as men."

Less Treatment, Greater Risk?

The design of the CDC study did not allow the researchers to address this question. But cardiologist Nanette Wenger, MD, tells WebMD that less aggressive treatment appears to be a contributing factor.

Wenger is chief of cardiology at Grady Memorial Hospital in Atlanta and is a professor of medicine at Atlanta's Emory University School of Medicine.

"Diabetics don't die of diabetes, they die of cardiovascular disease," she says. "It is clear that women in general receive fewer interventions to lower cardiovascular risk, and this is probably even more true of women with
diabetes."

In an editorial accompanying the study, Wenger suggests that women with diabetes may be at greater risk for cardiovascular events than men with the disease.

The study and editorial appear in the latest online issue of the journal Annals of Internal Medicine.

Newer Data Suggest Improvement

The CDC study showed no decline in death rates among women with diabetes during the three decades leading up to the year 2000, but there are hints that improvements may have occurred in the years since.

Earlier this year, government researchers announced a steady decline in heart-related deaths among women in the United States between the years 2000 and 2004, paralleling a rising awareness among women of their risk of dying from heart disease.

And a report released this week by another government agency showed major improvements in the treatment of women with diabetes between 2000 and 2003.

The Agency for Healthcare Research and Quality report concluded that "women are now about as likely as men to get recommended screening tests and treatments to manage their diabetes."

"It is clear that something has driven the decrease in heart disease mortality among women over the last five years," Wenger says.

She adds that it is not clear if the trend extends to women with diabetes.

"That remains to be seen, but there is cause for optimism," she adds.

By Salynn Boyles
Reviewed by Louise Chang
B)2005-2006 WebMD, Inc. All rights reserved