Improvements in mortality trends for people with diabetes in the United States appear to be limited to men, with the disease continuing to greatly increase the risk of death for women. Using data from the National Health and Nutrition Examination Surveys spanning the period from 1971 to 2000, researchers analysed mortality data in self-reported diabetics and compared the results with the non-diabetic population. Men with diabetes showed a 43% relative reduction in mortality rate, a result similar to that for non-diabetic men. Mortality rates did not decrease among women with diabetes. Moreover, the difference in mortality rates between diabetic and non-diabetic women doubled. Limitations of the study include the reliance on self-reporting of diabetes, changes in diagnostic criteria over time, and the relatively small samples in the sex-specific analysis. Despite these problems, the authors surmise that the observed trend in mortality is significant, and postulate that the result may be secondary to differences in the pathophysiology, diagnosis, and treatment of cardiovascular disease and diabetic complications in women.
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