You are here

Article Text

Article menu

Download PDFPDF

XML
Diabetes and endocrinology
Research
Sex differences in survival of patients with type 2 diabetes in primary care (ZODIAC-50)
  1. Steven H Hendriks1,
  2. Kornelis J J van Hateren2,
  3. Klaas H Groenier3,
  4. Gijs W D Landman2,4,
  5. Angela H E M Maas5,
  6. Henk J G Bilo1,6,7,
  7. Nanne Kleefstra2,6
  1. 1 Diabetes Centre, Isala, Zwolle, The Netherlands
  2. 2 Langerhans Medical Research Group, Zwolle, The Netherlands
  3. 3 Department of General Practice, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
  4. 4 Department of Internal Medicine, Gelre hospital, Apeldoorn, The Netherlands
  5. 5 Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
  6. 6 Department of Internal Medicine, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
  7. 7 Department of Internal Medicine, Isala, Zwolle, The Netherlands
  1. Correspondence to Steven H Hendriks; shhendriks{at}outlook.com

Abstract

Objective To investigate sex differences in survival of primary care treated patients with type 2 diabetes (T2D) in the Netherlands.

Setting Primary care.

Participants A total of 1815 patients who participated in a prospective observational cohort study (Zwolle Outpatient Diabetes Project Integrating Available Care (ZODIAC)) were included of which 56% was female. Inclusion took place in 1998, 1999 and 2001. Vital status was assessed in 2013.

Main outcome measure Relative survival of men and women with T2D. The relative survival rate was expressed as the ratio of observed survival of patients divided by the survival of the general population in the Netherlands with comparable age.

Results After 14 years, 888 (49%) patients had died. The relative survival rate was 0.88 (0.81–0.94) for men and 0.82 (0.76–0.87) for women with T2D after 14 years (p value for difference between sexes=0.169). In patients without a history of cardiovascular diseases (CVD), the relative survival was 0.99 (0.94–1.05) in men and 0.92 (0.87–0.97) in women (p value for difference between sexes=0.046).

Conclusions The survival of men and women with T2D was 12% and 18% lower, respectively, after 14 years of follow-up compared with men and women in the general population. This corresponds to a decrease in median survival of 2.2 and 3.5 years in men and women, respectively. Only for patients with T2D without a history of CVD, a significantly lower relative survival in women compared with men with T2D was found.

  • type 2 diabetes
  • sex differences
  • relative survival

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-015870

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors SHH, KJJH, KHG, HJGB and NK designed the study. SHH, KJJH and GWDL acquired the data. SHH, KJJH and KHG analysed the data. SHH, KJJH, KHG, GWDL, AHEMM, HJGB and NK interpreted the data. SHH and KJJH drafted the manuscript. KHG, GWDL, AHEMM, HJGB and NK reviewed and edited the manuscript. All authors read and approved the final manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval This study was approved by the local ethical committee of Isala, Zwolle, the Netherlands. All patients gave written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.