Sex disparity in the management of dyslipidemia among patients with type 2 diabetes mellitus in a managed care organization

Am J Manag Care. 2005 Feb;11(2):69-73.

Abstract

Objective: To determine whether there were sex-related differences in the management of dyslipidemia among managed care enrollees with diabetes mellitus.

Study design and methods: Retrospective analyses were conducted using medical and pharmacy claims data from a health maintenance organization during 2000 and 2001. Patients with type 2 diabetes mellitus were identified through a validated algorithm of medication and diagnosis codes. Chi-squared analysis was used to determine if women were less likely than men to receive a lipid test or a lipid-modifying drug. Logistic regression models were constructed to compare sex-related differences while controlling for age, cardiovascular disease diagnosis, and 2 proxies of illness severity (hospitalization in 2000 and the intensity of diabetes mellitus drug therapy).

Results: During 2000 and 2001, 79.4% of women received a lipid test compared with 84.2% of men (chi2 = 6.69, P = .01). Also, 33.2% of women received a lipid-modifying drug compared with 45.5% of men (chi2 = 27.31, P < .01). Logistic regression analysis revealed that men were more likely than women to receive a lipid test when controlling for age, cardiovascular disease diagnosis, and illness severity (odds ratio [OR], 1.45; 95% confidence interval, 1.13-1.81). Men were also more likely than women to receive a lipid-modifying drug when controlling for age, cardiovascular disease diagnosis, illness severity, and lipid testing (OR, 1.51; 95% confidence interval, 1.22-1.86).

Conclusion: Women with type 2 diabetes mellitus were less likely than men with type 2 diabetes mellitus to receive lipid tests or lipid-modifying drugs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / therapy*
  • Diabetic Angiopathies / prevention & control*
  • Diabetic Angiopathies / therapy
  • Diagnostic Tests, Routine / statistics & numerical data*
  • Female
  • Health Services Accessibility
  • Humans
  • Hyperlipidemias / drug therapy
  • Hyperlipidemias / etiology
  • Hyperlipidemias / prevention & control*
  • Male
  • Managed Care Programs / standards*
  • Middle Aged
  • Midwestern United States
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors
  • Women's Health*