The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: A 13-year follow-up study

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The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care : A 13-year follow-up study. / Krag, Marlene Øhrberg; Hasselbalch, Lotte; Siersma, Volkert Dirk; Nielsen, Anni Brit Sternhagen; Reventlow, Susanne; Malterud, Kirsti; Olivarius, Niels de Fine.

In: Diabetologia, Vol. 59, No. 2, 02.2016, p. 275-285.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Krag, MØ, Hasselbalch, L, Siersma, VD, Nielsen, ABS, Reventlow, S, Malterud, K & Olivarius, NDF 2016, 'The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: A 13-year follow-up study', Diabetologia, vol. 59, no. 2, pp. 275-285. https://doi.org/10.1007/s00125-015-3804-4

APA

Krag, M. Ø., Hasselbalch, L., Siersma, V. D., Nielsen, A. B. S., Reventlow, S., Malterud, K., & Olivarius, N. D. F. (2016). The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: A 13-year follow-up study. Diabetologia, 59(2), 275-285. https://doi.org/10.1007/s00125-015-3804-4

Vancouver

Krag MØ, Hasselbalch L, Siersma VD, Nielsen ABS, Reventlow S, Malterud K et al. The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: A 13-year follow-up study. Diabetologia. 2016 Feb;59(2):275-285. https://doi.org/10.1007/s00125-015-3804-4

Author

Krag, Marlene Øhrberg ; Hasselbalch, Lotte ; Siersma, Volkert Dirk ; Nielsen, Anni Brit Sternhagen ; Reventlow, Susanne ; Malterud, Kirsti ; Olivarius, Niels de Fine. / The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care : A 13-year follow-up study. In: Diabetologia. 2016 ; Vol. 59, No. 2. pp. 275-285.

Bibtex

@article{b995ac28e3c54aa8ad4766d865b121e6,
title = "The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: A 13-year follow-up study",
abstract = "Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus.Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical education of general practitioners participating in the intervention. Patients were re-examined at the end of intervention. This observational analysis followed 970 patients for 13 years thereafter using national registries. Outcomes were all-cause mortality, incidence of diabetes-related death, any diabetes-related endpoint, myocardial infarction, stroke, peripheral vascular disease and microvascular disease.Results: In women, but not men, a lower HR for structured personal care vs routine care emerged for any diabetes-related endpoint (0.65, p = 0.004, adjusted; 73.4 vs 107.7 events per 1,000 patient-years), diabetes-related death (0.70, p = 0.031; 34.6 vs 45.7), all-cause mortality (0.74, p = 0.028; 55.5 vs 68.5) and stroke (0.59, p = 0.038; 15.6 vs 28.9). This effect was different between men and women for diabetes-related death (interaction p = 0.015) and all-cause mortality (interaction p = 0.005).Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant after extensive multivariate adjustment. These observational results from a post hoc analysis of a randomised controlled trial cannot be explained by intermediate outcomes like HbA1c alone, but involves complex social and cultural issues of gender. There is a need to rethink treatment schemes for both men and women to gain benefit from intensified treatment efforts.",
keywords = "The Faculty of Health and Medical Sciences, Gender, General Practice, Intervention, Mortality, Myocardial Infarction, Primary Care, Stroke, Type 2 Diabetes Mellitus, Gender, General Practice, Intervention, Mortality, Myocardial Infarction, Primary Care, Sex, Stroke, Tye 2 diabetes mellitus",
author = "Krag, {Marlene {\O}hrberg} and Lotte Hasselbalch and Siersma, {Volkert Dirk} and Nielsen, {Anni Brit Sternhagen} and Susanne Reventlow and Kirsti Malterud and Olivarius, {Niels de Fine}",
year = "2016",
month = "2",
doi = "10.1007/s00125-015-3804-4",
language = "English",
volume = "59",
pages = "275--285",
journal = "Diabetologia",
issn = "0012-186X",
publisher = "Springer",
number = "2",

}

RIS

TY - JOUR

T1 - The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care

T2 - A 13-year follow-up study

AU - Krag, Marlene Øhrberg

AU - Hasselbalch, Lotte

AU - Siersma, Volkert Dirk

AU - Nielsen, Anni Brit Sternhagen

AU - Reventlow, Susanne

AU - Malterud, Kirsti

AU - Olivarius, Niels de Fine

PY - 2016/2

Y1 - 2016/2

N2 - Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus.Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical education of general practitioners participating in the intervention. Patients were re-examined at the end of intervention. This observational analysis followed 970 patients for 13 years thereafter using national registries. Outcomes were all-cause mortality, incidence of diabetes-related death, any diabetes-related endpoint, myocardial infarction, stroke, peripheral vascular disease and microvascular disease.Results: In women, but not men, a lower HR for structured personal care vs routine care emerged for any diabetes-related endpoint (0.65, p = 0.004, adjusted; 73.4 vs 107.7 events per 1,000 patient-years), diabetes-related death (0.70, p = 0.031; 34.6 vs 45.7), all-cause mortality (0.74, p = 0.028; 55.5 vs 68.5) and stroke (0.59, p = 0.038; 15.6 vs 28.9). This effect was different between men and women for diabetes-related death (interaction p = 0.015) and all-cause mortality (interaction p = 0.005).Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant after extensive multivariate adjustment. These observational results from a post hoc analysis of a randomised controlled trial cannot be explained by intermediate outcomes like HbA1c alone, but involves complex social and cultural issues of gender. There is a need to rethink treatment schemes for both men and women to gain benefit from intensified treatment efforts.

AB - Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus.Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical education of general practitioners participating in the intervention. Patients were re-examined at the end of intervention. This observational analysis followed 970 patients for 13 years thereafter using national registries. Outcomes were all-cause mortality, incidence of diabetes-related death, any diabetes-related endpoint, myocardial infarction, stroke, peripheral vascular disease and microvascular disease.Results: In women, but not men, a lower HR for structured personal care vs routine care emerged for any diabetes-related endpoint (0.65, p = 0.004, adjusted; 73.4 vs 107.7 events per 1,000 patient-years), diabetes-related death (0.70, p = 0.031; 34.6 vs 45.7), all-cause mortality (0.74, p = 0.028; 55.5 vs 68.5) and stroke (0.59, p = 0.038; 15.6 vs 28.9). This effect was different between men and women for diabetes-related death (interaction p = 0.015) and all-cause mortality (interaction p = 0.005).Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant after extensive multivariate adjustment. These observational results from a post hoc analysis of a randomised controlled trial cannot be explained by intermediate outcomes like HbA1c alone, but involves complex social and cultural issues of gender. There is a need to rethink treatment schemes for both men and women to gain benefit from intensified treatment efforts.

KW - The Faculty of Health and Medical Sciences

KW - Gender

KW - General Practice

KW - Intervention

KW - Mortality

KW - Myocardial Infarction

KW - Primary Care

KW - Stroke

KW - Type 2 Diabetes Mellitus

KW - Gender

KW - General Practice

KW - Intervention

KW - Mortality

KW - Myocardial Infarction

KW - Primary Care

KW - Sex

KW - Stroke

KW - Tye 2 diabetes mellitus

U2 - 10.1007/s00125-015-3804-4

DO - 10.1007/s00125-015-3804-4

M3 - Journal article

VL - 59

SP - 275

EP - 285

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

IS - 2

ER -

ID: 145632186