Cardiovascular Disease Prevention and Therapy in Women With Type 2 Diabetes

Abstract

Cardiovascular disease (CVD) is the leading cause of death among men and women, although women are usually underdiagnosed and experience a delay in diagnosis. This also occurs in women with type 2 diabetes mellitus, despite the fact that diabetes is recognized as a major cardiovascular risk factor. Several factors influence the gap between diagnosis and treatment of cardiovascular disease in women: lack of perception of cardiovascular risk, effects of sex-related risk factors and the action of drugs in women. Women with Type 2 diabetes mellitus are more likely to be assigned a lower CVD risk category and to receive lifestyle counseling as well as less intensive CVD therapy compared with men. The present narrative review aims to analyze the risk of CVD in women with Type 2 diabetes mellitus and whether there is a difference between men and women in the efficacy of SGLT-2 inhibitors, new hypoglycemic drugs.

Lay abstract Despite the fact that cardiovascular disease is the most frequent cause of death in women in industrialized countries, the idea that it affects mainly men and affects women only after menopause still persists. This results in underdiagnosis and undertreatment of cardiovascular disease in women. This phenomenon depends on various factors, including lack of perception of risk in women themselves, reduced social action regarding prevention of cardiovascular disease risk factors in women and lower presence of women in the populations included in scientific studies. The condition is also present in women with Type 2 diabetes mellitus, who have a high risk of developing cardiovascular disease even before menopause. This review is aimed at exploring the factors that determine an underestimation of cardiovascular risk in women with Type 2 diabetes mellitus. Failure to identify risk carries a high social and economic cost.

Keywords:

• diabetes
• lifestyle
• prevention
• women

Author contributions

AV Mattioli and A Farinetti conceived of the idea upon which the article is based. C Cocchi, AV Mattioli, F Coppi and A Farinetti developed the different parts of the manuscript and performed the final supervision. All authors contributed to and approved the final manuscript.

Acknowledgments

The authors thank JA Carter for editing the article.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.