SEX DIFFERENCES IN CARDIOMETABOLIC RISK FACTORS IN A TYPE 2 DIABETES POPULATION

AN INTERIM ANALYSIS OF THE TARGET-T2D STUDY IN MALAYSIA

Abstract

OBJECTIVES
This study aimed to examine differences in the control and treatment of cardiometabolic risk factors between males and females with type 2 diabetes (T2D) in Malaysia.

METHODOLOGY
The TARGET-T2D study, an ongoing cross-sectional study (December 2021–June 2022), involves T2D adults treated with lifestyle modification with and without oral/injectable glucose-lowering drugs for ≥12 months in outpatient settings. We included 8 tertiary public hospitals in the Greater Kuala Lumpur region. In this interim analysis (13 December 2021–31 March 2022), we compared the attainment rates of ABC targets (HbA1c<7%, Blood pressure [BP]<130/80 mm Hg, LDL-Cholesterol <1.8 mmol/L) and use of cardiorenal-protective drugs (sodium-glucose co- transporter-2 inhibitors [SGLT2i], glucagon-like peptide-1 receptor analogues, renin-angiotensin system inhibitors [RASi], statins) by sex.

RESULTS
Among 2532 patients (mean HbA1c 8.2 ± 2.0%, mean body mass index 29.8 ± 6.4 kg/m2, 54.4% females), females were younger and less likely to smoke than males. Of the entire cohort, 99.5% were at ESC high-/very high cardiovascular risk categories, wherein 70.3% of females and 78.6% of males were at very high-risk (p<0.001). Compared with males, more females attained BP <130/80 mm Hg (68.8% versus 62.2%; p<0.001), but not LDL-cholesterol <1.8 mmol/L (21.8% versus 31.5%; p<0.001) and all ABC targets (5.2% versus 7.3%; p=0.040). Fewer females were treated with SGLT2i (37.9% versus 44.2%; p=0.002), RASi (63.0%
versus 69.6%; p<0.001) and statins (87.8% versus 92.6%; p<0.001) than males.

CONCLUSION
In this very high-risk T2D group, more males attained optimal risk factor control than females. Health services and mechanistic research are needed to explain the differences in risk profiles and treatment patterns.