Sex and age differences in the use of medications for diabetes and cardiovascular risk factors among 25,733 people with diabetes

Crystal M Y Lee; Alice A Gibson; Jacob Humphries; Natasha Nassar; Stephen Colagiuri

doi:10.1371/journal.pone.0287599

Sex and age differences in the use of medications for diabetes and cardiovascular risk factors among 25,733 people with diabetes

PLoS One. 2023 Oct 24;18(10):e0287599. doi: 10.1371/journal.pone.0287599. eCollection 2023.

Authors

Crystal M Y Lee^{1

2}, Alice A Gibson^{3

4}, Jacob Humphries¹, Natasha Nassar^{3

4}, Stephen Colagiuri^{1

4}

Affiliations

¹ Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
² School of Population Health, Curtin University, Perth, Western Australia, Australia.
³ Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
⁴ Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.

Abstract

Aim: To determine sex and age differences in the use of medications for diabetes and cardiovascular risk factors in people with diabetes in Australia.

Methods: Pharmaceutical claims data of participants in the 45 and Up Study who self-reported having diabetes before 2013, were alive on 1st January 2013 and had at least one medication dispensing record between 1st January 2013 and 31st December 2019 were analysed. Annual sex and age-specific percentages of participants supplied specific medications were estimated for years 2013 to 2019. Percentages were reported for any glucose lowering medications and by drug class, any lipid modifying agents, and any blood pressure lowering medications.

Results: Altogether 25,733 participants (45.2% women) with diabetes were included. The percentage of participants who were supplied with glucose lowering medications was consistently lower in women compared to men. In both sexes, the percentage of participants who were supplied with glucose lowering medications was lowest among those aged ≥75 years and this decreased over time. Similar findings were observed for lipid modifying agents and blood pressure lowering medications. The use of sodium glucose co-transporter 2 inhibitors increased substantially in participants aged <75 years since it became available in 2013. However, no sex differences were observed in its use among people with hospital-recorded history of cardiovascular disease.

Conclusions: Practitioners should be aware of possible sex disparities in the pharmacological treatment of diabetes and cardiovascular risk factors in people with diabetes in Australia. There is a possible time lag between reporting of research findings and uptake of sodium glucose co-transporter 2 inhibitors prescribing in individuals with diabetes and high cardiovascular risk in clinical practice, nevertheless, the result observed was consistent with the management guidelines at the time of the study.

Copyright: © 2023 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / drug therapy
Cardiovascular Diseases* / epidemiology
Diabetes Mellitus* / drug therapy
Diabetes Mellitus* / epidemiology
Diabetes Mellitus, Type 2* / drug therapy
Female
Glucose / therapeutic use
Heart Disease Risk Factors
Humans
Hypoglycemic Agents / therapeutic use
Lipids / therapeutic use
Male
Pharmaceutical Preparations
Risk Factors
Sodium
Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
Symporters*

Substances

Sodium-Glucose Transporter 2 Inhibitors
Pharmaceutical Preparations
Lipids
Glucose
Symporters
Sodium
Hypoglycemic Agents

Grants and funding

This work was supported by a Diabetes Australia Research Program General Grant (Y20G-LEEC). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation for the manuscript. AAG is supported by an NHMRC Emerging Leader 1 Investigator Grant (1173784). NN is supported by the Financial Markets Foundation for Children and NHMRC Leadership Grant (APP1197940).