Sex and gender differences in therapy of type 2 diabetes

Kautzky‐Willer, Alexandra; Harreiter, Jürgen

doi:10.1016/j.diabres.2017.07.012

Cited by 98 publications

(115 citation statements)

References 101 publications

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“…A previous study showed that ADRs experienced by people with diabetes can be transient or fluctuating over time [22] but it is not clear whether this differs between men and women. This could in part be a gender-related factor, since social, behavioral, and cultural differences between men and women may influence the experience and reporting of ADRs [15,23,24]. Women and men have different risk perceptions [25] and it has been shown that women more often read patient information leaflets than men [26].…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Adverse Drug Reactions of Metformin: A Longitudinal Survey Study

et al. 2020

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Introduction In general, women more often experience metformin-associated adverse drug reactions (ADRs) than men. Objectives We aimed to assess whether sex differences in reported ADRs for metformin are observed at different times after initiation, and to explore their concurrence with sex differences in the dose of metformin over time. This may guide future studies in assessing the involved mechanisms of sex differences in metformin-associated ADRs and may guide sex-specific management of ADRs in clinical practice. Methods This study has a longitudinal design using data about patients initiating metformin collected by the Dutch National Pharmacovigilance Center Lareb through their Intensive Monitoring program. Patients were asked to complete a web-based questionnaire six times after initiation (i.e., at 2 weeks, 6 weeks and at 3, 6, 9, and 12 months). The outcome variables were the proportion of patients reporting any ADR (primary) and the dose of metformin (secondary). Sex differences in the proportions of ADRs and in the dose were tested at each assessment using Pearson Chi-Squared tests and Wilcoxon rank-sum tests, respectively. Using Bonferroni adjustment for multiple testing, a p value < 0.01 was considered statistically significant. Results The number of included patients was 1712 (40.9% women). Women reported an ADR more often than men, which was statistically significant at the assessment at 2 weeks (34% vs 25%, p < 0.001), and 6 weeks (37% vs 28%, p = 0.001) after initiation. In general, women were reported to be prescribed a lower dose than men, which became statistically significant at the 9-month assessment (p < 0.01). Conclusions Sex differences in reported ADRs were seen in the first weeks after metformin initiation, whereas statistically significant differences in self-reported prescribed dosing were observed after several months. Patients, in particular women, might benefit from being prescribed lower metformin doses at treatment initiation.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in Adverse Drug Reactions of Metformin: A Longitudinal Survey Study

et al. 2020

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“…Diabetes mellitus type 2 (T2DM) is a long term, life-threatening metabolic disorder characterized by high systemic glucose levels, insulin resistance and damage to many tissues due to dysregulated inflammation [ 1 , 2 , 3 ]. Unfortunately for those afflicted, this disease persists for a lifetime and progressively causes a wide range of debilitating effects, prominently: retinopathy, nephropathy, myocardial infarction, stroke, and damage to extremities severe enough to require amputation [ 4 , 5 ]. Pharmacotherapy for T2DM includes insulin analogues, biguanids, sulfonylureas, α-glucosidase inhibitors, thiazolidinediones, SGLT-2-inhibitors, GLP-1 analogues, DPP-4-inhibitors, amylin analogues.…”

Section: Introductionmentioning

confidence: 99%

Long Term Osmotic Mini Pump Treatment with Alpha-MSH Improves Myocardial Function in Zucker Diabetic Fatty Rats

et al. 2017

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The present investigation evaluates the cardiovascular effects of the anorexigenic mediator alpha-melanocyte stimulating hormone (MSH), in a rat model of type 2 diabetes. Osmotic mini pumps delivering MSH or vehicle, for 6 weeks, were surgically implanted in Zucker Diabetic Fatty (ZDF) rats. Serum parameters, blood pressure, and weight gain were monitored along with oral glucose tolerance (OGTT). Echocardiography was conducted and, following sacrifice, the effects of treatment on ischemia/reperfusion cardiac injury were assessed using the isolated working heart method. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity was measured to evaluate levels of oxidative stress, and force measurements were performed on isolated cardiomyocytes to determine calcium sensitivity, active tension and myofilament co-operation. Vascular status was also evaluated on isolated arterioles using a contractile force measurement setup. The echocardiographic parameters ejection fraction (EF), fractional shortening (FS), isovolumetric relaxation time (IVRT), mitral annular plane systolic excursion (MAPSE), and Tei-index were significantly better in the MSH-treated group compared to ZDF controls. Isolated working heart aortic and coronary flow was increased in treated rats, and higher Hill coefficient indicated better myofilament co-operation in the MSH-treated group. We conclude that MSH improves global heart functions in ZDF rats, but these effects are not related to the vascular status.

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“…Des Weiteren wurde für Frauen bestätigt, dass anamnestisch erhobene reproduktive Faktoren (Parität, Zyklusunregelmäßigkeiten, Präeklampsie, frühe Menopause) sowie insbesondere eine Anamnese eines früheren GDM mit dem Ausmaß der aktuellen Stoffwechselstörung eng assoziiert sind [9]. Frauen mit einem früheren GDM konvertierten bei vergleichbarer [23,25].…”

Section: Lebensstil Und Präventionunclassified

“…Geschlechtsspezifische Unterschiede in der multifaktoriellen medikamentösen Therapie des Typ-2-Diabetes[23,36] Geschlechtsspezifische Unterschiede bei diabetesassoziierten Komplikationen und Komorbiditäten. (Nach[4,37])…”

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Geschlechtsspezifische Aspekte bei Prädiabetes und Diabetes mellitus – klinische Empfehlungen (Update 2019)

Kautzky‐Willer

Harreiter

Abrahamian

et al. 2019

Wien Klin Wochenschr

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Zusammenfassung Metabolische Erkrankungen beeinflussen das Leben von Männern und Frauen in den verschiedenen Lebensabschnitten in unterschiedlicher und vielfältiger Weise und stellen eine große Herausforderung für das Gesundheitssystem dar. Die behandelnden Ärztinnen und Ärzte sind mit den unterschiedlichen Bedürfnissen von Männern und Frauen im klinischen Alltag konfrontiert. Geschlechtsspezifische Unterschiede beeinflussen Screening, Diagnose und Behandlungsstrategien sowie die Entwicklung von Komplikationen und die Mortalitätsraten. A. Kautzky-Willer ( ) · J. Harreiter

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Sex and gender differences in therapy of type 2 diabetes

Cited by 98 publications

References 101 publications

Sex Differences in Adverse Drug Reactions of Metformin: A Longitudinal Survey Study

Sex Differences in Adverse Drug Reactions of Metformin: A Longitudinal Survey Study

Long Term Osmotic Mini Pump Treatment with Alpha-MSH Improves Myocardial Function in Zucker Diabetic Fatty Rats

Geschlechtsspezifische Aspekte bei Prädiabetes und Diabetes mellitus – klinische Empfehlungen (Update 2019)

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