medwireNews: Women are more likely to attend guideline-recommended diabetes screening than men, but rates are “suboptimal” in both sexes, particularly among younger individuals, show population-based study data from Canada.
The REDISCOVER study also found that although men have lower screening rates than women, they have a higher incidence of prediabetes and diabetes.
Padma Kaul (University of Alberta, Edmonton) and co-investigators therefore say: “Further research is needed to understand the underlying causes of sex differences in adherence to diabetes screening and to develop targeted strategies at the local and population level to raise awareness and improve screening rates in young people, especially males.”
The study included data for 1,380,697 Alberta residents (49.2% men) with no pre-existing diabetes who were over the age of 40 years between 2013 and 2016.
In Canada, the recommendation is that all adults over the age of 40 years are screened for diabetes at least once every 3 years.
Kaul and co-authors report in The Lancet Regional Health – Americas that 69.9% of men and 79.8% of women followed that recommendation in the current cohort.
Men had lower screening rates than women across all age groups, but the difference between the two sexes was greatest in those aged 40–44 years, at 58.0% and 72.6%, respectively. The corresponding rates among individuals aged 70–79 years were 84.8% and 87.4%.
After adjustment for age, urban or rural residence, and material deprivation level, women were a significant 1.92 times more likely to attend screening as advised than men.
In addition, the researchers found that older individuals were more likely to attend than their younger counterparts, with the difference reaching fourfold by the age of 70 years, compared with those aged 40–44 years.
Rural residents were slightly but significantly less likely to follow screening guidelines than people living in urban areas but people living in neighborhoods with higher levels of material deprivation were more likely to attend screening than individuals living in the least deprived neighborhoods.
During the screening period, prediabetes was diagnosed in 15.7% of men and 13.4% of women who followed screening guidelines, while diabetes was detected in 2.6% and 1.5%, respectively.
The participants were then followed up for an additional 4 years. During this time, 24.9% of appropriately screened men and 19.5% of the women had prediabetes. After excluding individuals who had diabetes during the screening period, a further 3.2% of men and 1.9% of women had incident diabetes during follow-up.
By comparison, prediabetes incidence during follow-up was 8.8% and 7.3% in men and women who did not follow screening guidelines, respectively, and diabetes incidence was a corresponding 2.1% and 1.3%.
“The higher rates among adherent individuals suggest that individuals who may be at higher risk for diabetes are being screened early,” Kaul et al remark.
However, they add that “the combined incidence of prediabetes and diabetes was substantial among non-adherent individuals (10.9% among males and 8.6% among females) indicating potential missed opportunities to identify these individuals earlier.”
The investigators also note that during the entire 7-year study period, approximately 20% of men younger than 50 years of age did not receive a glucose test, compared with 10% of women.
They therefore conclude: “Public health campaigns about the importance of annual check-ups, diabetes screening, and interventions such as workplace screening programs, particularly targeted towards young males need to be considered.”
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