Men are more likely to die from diabetes because they are too macho to follow tailored treatment plans, researchers declared today.
Women given specific recommendations about diet and exercise were 30 per cent less likely to die from diabetes-related causes than those given routine care, Danish scientists found.
But the same tailored advice given to men had no impact on their mortality.
Dr Marlene Krag, from the University of Copenhagen, said structured personal diabetes care could provide women with significant attention and support – thereby helping them to stick to treatment plans.
She said: ‘Women accept disease and implement disease management more easily, which might affect long-term outcomes.’
On the other hand, she added that masculinity may be challenged by diabetes, demanding daily consideration and lifestyle changes.
Essentially, the structured approach of such diabetes care goes against ‘men’s tendency to trust self-directed learning instead of self-management’.
The study, published in the journal Diabetologia, assessed the impact of a trial in Denmark which provided tailored treatment on exercise and diet to patients between 1989 and 1995.
Doctors were encouraged to stress the importance of diet and physical activity, delay the use of diabetes drugs until they assessed the effect of any diet and exercise, and give patients individual targets that were reviewed quarterly.
Those in a control group were free to choose any treatment and to change it over time, as they normally would.
After six years of tailored treatment, no effect was seen on mortality and other anticipated non-fatal effects.
But of those receiving structured treatment, there was a difference at the end of the trial – women had lower blood glucose levels.
In the latest study, the authors followed the participants of the original study for 13 years until 2008.
Of the 970 patients from the original 1,381 who survived, 478 women and 492 men were re-examined.
The results showed women given personal care plans were 26 per cent less likely to die of any cause and 30 per cent less likely to die of a diabetes-related cause than women given routine care.
They were also 41 per cent less likely to suffer a stroke, and 35 per cent less likely to experience any diabetes-related end-point such as amputation or blindness.
However none of these differences were seen between the men who received personal care or routine care, but the differences between the sexes were only statistically significant for all-cause mortality and diabetes-related death.
The authors concluded: ‘We propose that the improved outcomes in women may be explained by complex social and cultural issues of gender.’
They added there was now a need to re-think the way care was provided to men and women, ‘so that both sexes benefit from intensified treatment efforts’.
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