{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:03:12Z","timestamp":1789646592198,"version":"4.0.0"},"reference-count":35,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":2905,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To investigate the quality of type 2 diabetes care according to sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Clinical data collected during the year 2009 were extracted from electronic medical records; quality-of-care indicators were evaluated. Multilevel logistic regression analysis was applied to estimate the likelihood of women versus men to be monitored for selected parameters, to reach clinical outcomes, and to be treated with specific classes of drugs. The intercenter variability in the proportion of men and women achieving the targets was also investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 415,294 patients from 236 diabetes outpatient centers were evaluated, of whom 188,125 (45.3%) were women and 227,169 (54.7%) were men. Women were 14% more likely than men to have HbA1c &amp;gt;9.0% in spite of insulin treatment (odds ratio 1.14 [95% CI 1.10\u20131.17]), 42% more likely to have LDL cholesterol (LDL-C) \u2265130 mg\/dL (1.42 [1.38\u20131.46]) in spite of lipid-lowering treatment, and 50% more likely to have BMI \u226530 kg\/m2 (1.50 [1.50\u20131.54]). Women were less likely to be monitored for foot and eye complications. In 99% of centers, the percentage of men reaching the LDL-C target was higher than in women, the proportion of patients reaching the HbA1c target was in favor of men in 80% of the centers, and no differences emerged for blood pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Women show a poorer quality of diabetes care than men. The attainment of the LDL-C target seems to be mainly related to pathophysiological factors, whereas patient and physician attitudes can play an important role in other process measures and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc13-0184","type":"journal-article","created":{"date-parts":[[2013,7,8]],"date-time":"2013-07-08T23:18:14Z","timestamp":1373325494000},"page":"3162-3168","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":109,"title":["Sex Disparities in the Quality of Diabetes Care: Biological and Cultural Factors May Play a Different Role for Different Outcomes"],"prefix":"10.2337","volume":"36","author":[{"given":"Maria Chiara","family":"Rossi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Chieti, Abruzzo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Cristofaro","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology Unit, Cardarelli Hospital, Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Gentile","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lucisano","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Chieti, Abruzzo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Manicardi","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Montecchio Hospital, Montecchio Emilia (RE), Emilia-Romagna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Franca","family":"Mulas","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolic Diseases Unit, San Martino Hospital, Oristano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Napoli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, S. Andrea Hospital, Sapienza University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Nicolucci","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Chieti, Abruzzo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Chieti, Abruzzo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Suraci","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Unit, Sandro Pertini Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Giorda","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Unit, ASL TO5, Chieri (TO), Turin, Piedmont, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the AMD Annals Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2013,9,14]]},"reference":[{"key":"2022031221110351000_B1","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/j.1553-2712.2012.01389.x","article-title":"Gender-specific medicine: yesterday\u2019s neglect, tomorrow\u2019s opportunities","volume":"19","author":"McGregor","year":"2012","journal-title":"Acad Emerg Med"},{"key":"2022031221110351000_B2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S1550-8579(06)80202-0","article-title":"Gender-specific care of the patient with diabetes: review and recommendations","volume":"3","author":"Legato","year":"2006","journal-title":"Gend Med"},{"key":"2022031221110351000_B3","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.2337\/diacare.27.12.2898","article-title":"Gender difference in the impact of type 2 diabetes on coronary heart disease risk","volume":"27","author":"Juutilainen","year":"2004","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1136\/bmj.38678.389583.7C","article-title":"Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies","volume":"332","author":"Huxley","year":"2006","journal-title":"BMJ"},{"key":"2022031221110351000_B5","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1001\/archinte.162.15.1737","article-title":"Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis","volume":"162","author":"Kanaya","year":"2002","journal-title":"Arch Intern Med"},{"key":"2022031221110351000_B6","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1093\/eurheartj\/ehr027","article-title":"Factors influencing underutilization of evidence-based therapies in women","volume":"32","author":"Bugiardini","year":"2011","journal-title":"Eur Heart J"},{"key":"2022031221110351000_B7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ahj.2011.09.025","article-title":"Bridging the gender gap: Insights from a contemporary analysis of sex-related differences in the treatment and outcomes of patients with acute coronary syndromes","volume":"163","author":"Poon","year":"2012","journal-title":"Am Heart J"},{"key":"2022031221110351000_B8","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1007\/s11886-010-0135-4","article-title":"Recognizing and improving health care disparities in the prevention of cardiovascular disease in women","volume":"12","author":"Jarvie","year":"2010","journal-title":"Curr Cardiol Rep"},{"key":"2022031221110351000_B9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/j.1463-1326.2012.01591.x","article-title":"Glucose-lowering treatment and clinical results in 163 121 patients with type 2 diabetes: an observational study from the Swedish national diabetes register","volume":"14","author":"Ekstr\u00f6m","year":"2012","journal-title":"Diabetes Obes Metab"},{"key":"2022031221110351000_B10","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/j.1464-5491.2009.02837.x","article-title":"Which people with type 2 diabetes achieve good control of intermediate outcomes? Population database study in a UK region","volume":"26","author":"Guthrie","year":"2009","journal-title":"Diabet Med"},{"key":"2022031221110351000_B11","doi-asserted-by":"crossref","first-page":"774","DOI":"10.2337\/dc11-1679","article-title":"Control of glycemia and cardiovascular risk factors in patients with type 2 diabetes in primary care in Catalonia (Spain)","volume":"35","author":"Vinagre","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B12","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.2337\/dc08-0469","article-title":"Baseline quality-of-care data from a quality-improvement program implemented by a network of diabetes outpatient clinics","volume":"31","author":"Rossi","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B13","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1111\/j.1464-5491.2010.03055.x","article-title":"Four-year impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics: the AMD-Annals initiative","volume":"27","author":"Nicolucci","year":"2010","journal-title":"Diabet Med"},{"key":"2022031221110351000_B14","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.numecd.2006.04.009","article-title":"Quality of diabetes care predicts the development of cardiovascular events: results of the QuED study","volume":"18","author":"De Berardis","year":"2008","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2022031221110351000_B15","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2337\/dc10-1709","article-title":"Quality of diabetes care predicts the development of cardiovascular events: results of the AMD-QUASAR study","volume":"34","author":"Rossi","year":"2011","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B16","doi-asserted-by":"crossref","first-page":"785","DOI":"10.7326\/0003-4819-156-11-201203200-00391","article-title":"Estimating equations for glomerular filtration rate in the era of creatinine standardization: a systematic review","volume":"156","author":"Earley","year":"2012","journal-title":"Ann Intern Med"},{"key":"2022031221110351000_B17","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/MLR.0b013e31818dce07","article-title":"Improving the reliability of physician performance assessment: identifying the \u201cphysician effect\u201d on quality and creating composite measures","volume":"47","author":"Kaplan","year":"2009","journal-title":"Med Care"},{"key":"2022031221110351000_B18","first-page":"2","article-title":"The influence of gender on the primary care management of diabetes in Tunisia","volume":"3","author":"Alberti","year":"2009","journal-title":"Pan Afr Med J"},{"key":"2022031221110351000_B19","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1471-2261-9-30","article-title":"Gender-related differences in the prevalence of cardiovascular disease risk factors and their correlates in urban Tanzania","volume":"9","author":"Njelekela","year":"2009","journal-title":"BMC Cardiovasc Disord"},{"key":"2022031221110351000_B20","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.2337\/dc08-0194","article-title":"Sex disparities in the treatment and control of cardiovascular risk factors in type 2 diabetes","volume":"31","author":"Gouni-Berthold","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B21","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.genm.2010.12.001","article-title":"Sex-specific differences in metabolic control, cardiovascular risk, and interventions in patients with type 2 diabetes mellitus","volume":"7","author":"Kautzky-Willer","year":"2010","journal-title":"Gend Med"},{"key":"2022031221110351000_B22","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.whi.2007.03.001","article-title":"Does quality of care for cardiovascular disease and diabetes differ by gender for enrollees in managed care plans?","volume":"17","author":"Bird","year":"2007","journal-title":"Womens Health Issues"},{"key":"2022031221110351000_B23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2337\/dc07-1244","article-title":"Sex disparities in control and treatment of modifiable cardiovascular disease risk factors among patients with diabetes: Translating Research Into Action for Diabetes (TRIAD) Study","volume":"31","author":"Ferrara","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B24","doi-asserted-by":"crossref","first-page":"514","DOI":"10.2337\/diacare.28.3.514","article-title":"Sex disparities in treatment of cardiac risk factors in patients with type 2 diabetes","volume":"28","author":"Wexler","year":"2005","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B25","doi-asserted-by":"crossref","first-page":"S176","DOI":"10.1016\/j.whi.2011.04.009","article-title":"Gender disparities in lipid-lowering therapy among veterans with diabetes","volume":"21","author":"Vimalananda","year":"2011","journal-title":"Womens Health Issues"},{"key":"2022031221110351000_B26","first-page":"133","article-title":"Gender disparities in lipid management: the presence of disparities depends on the quality measure","volume":"12","author":"Kim","year":"2006","journal-title":"Am J Manag Care"},{"key":"2022031221110351000_B27","doi-asserted-by":"crossref","first-page":"111","DOI":"10.7326\/0003-4819-136-2-200201150-00008","article-title":"Profiling care provided by different groups of physicians: effects of patient case-mix (bias) and physician-level clustering on quality assessment results","volume":"136","author":"Greenfield","year":"2002","journal-title":"Ann Intern Med"},{"key":"2022031221110351000_B28","doi-asserted-by":"crossref","first-page":"398","DOI":"10.2337\/diacare.27.2.398","article-title":"Quality of care and outcomes in type 2 diabetic patients: a comparison between general practice and diabetes clinics","volume":"27","author":"De Berardis","year":"2004","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B29","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/00075197-200111000-00010","article-title":"Sex differences in carbohydrate metabolism","volume":"4","author":"Tarnopolsky","year":"2001","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2022031221110351000_B30","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.phrs.2006.11.001","article-title":"Gender differences in drug responses","volume":"55","author":"Franconi","year":"2007","journal-title":"Pharmacol Res"},{"key":"2022031221110351000_B31","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1503\/cmaj.060627","article-title":"Sex differences in the effectiveness of statins after myocardial infarction","volume":"176","author":"Karp","year":"2007","journal-title":"CMAJ"},{"key":"2022031221110351000_B32","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s00228-008-0494-6","article-title":"Women encounter ADRs more often than do men","volume":"64","author":"Zopf","year":"2008","journal-title":"Eur J Clin Pharmacol"},{"key":"2022031221110351000_B33","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2337\/dc11-1380","article-title":"Diverging association of reduced glomerular filtration rate and albuminuria with coronary and noncoronary events in patients with type 2 diabetes: the renal insufficiency and cardiovascular events (RIACE) Italian multicenter study","volume":"35","author":"Solini","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031221110351000_B34"},{"key":"2022031221110351000_B35","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511807305","volume-title":"Gender and Health: The Effects of Constrained Choices and Social Policies","author":"Bird","year":"2008"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/36\/10\/3162\/613755\/3162.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/36\/10\/3162\/613755\/3162.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T18:13:15Z","timestamp":1647108795000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/36\/10\/3162\/30595\/Sex-Disparities-in-the-Quality-of-Diabetes-Care"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,14]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2013,9,14]]},"published-print":{"date-parts":[[2013,10,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc13-0184","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,14]]}}}