RESUMO
The aim of present observational cross-sectional study was the estimation of the gender-related risk of non-fatal stroke, myocardial infarction and blindness in type 2 diabetics (T2D) depending on treatment in Ukraine. In Dec 2005 the data from 11 Ukrainian regions for all living T2D already included into the nationwide population-based diabetes register (start of creation Jan 2001) was extracted. Male/female relative risks (RRs) for non-fatal stroke, myocardial infarction and blindness were calculated in treatment groups: Diet only (DO) 7273/15901; oral antidiabetic drugs (OAD) 15109/ 33913; insulin (I) 5529/12462 male/female respectively. 95% confidence intervals were estimated using logarithmic transformation, chi-square test was used to compare the differences between groups. The higher prevalence of stroke among men was in those patients treated with OAD or DO:RRs = 1.38 (1.26-1.51) and 1.48 (1.25-1.76), respectively. The gender differences were absent among those treated with I:RR = 0.98 (0.87-1.10). An excess male risk of myocardial infarction was in persons treated with I:RR = 1.37 (1.21-1.55), though smaller than in those treated without I - male/female RRs: 2.18 (1.97-2.41) and 2.37 (1.99-2.86), respectively for OAD and DO (P<0.001 in both cases). The significantly increased female prevalence of blindness was in patients treated with I:RR = 0.80 (0.70-0.92). The latest is in accordance with our earlier results, which have demonstrated the raised prevalence of both low sight and proliferative retinopathy among the insulin-treated diabetic women. No sex-related differences in blindness prevalence were revealed in patients treated with OAD or DO. The gender risks of not-fatal stroke, myocardial infarction and blindness in T2D are significantly different depending on the fact of insulin treatment. Further research could clarify if it depends upon insulin-related hyperandrogenisation in T2D women.
