Relative risk of cardiovascular disease is higher in women with type 2 diabetes, but not in those with prediabetes, as compared with men

Objective: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men.

Research Design and Methods: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up.

Results: Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; P<0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; P<0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; P<0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; P<0.0001).

Conclusions: This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men.