Patients with chronic
diabetic complications experience high morbidity and mortality. Sex disparities in modifiable factors such as processes of care or self-care activities have not been explored in detail, particularly in these high-risk patients. Sex differences in processes of care and self-care activities were assessed in a cross-sectional analysis of the Pathways Study, an observational cohort of primary care diabetic patients from a managed care organization (N = 4,839). Compared to men, women had decreased odds of
dyslipidemia screening (adjusted odds ratio (AOR) 0.73, 95% CI 0.62-0.85), reaching
low-density lipoprotein goal (AOR 0.70, 95% CI 0.58-0.86), and
statin use (AOR 0.69, 95% CI 0.58-0.81); women had 19% greater odds of reaching
hemoglobin A1c <7% (95% CI 1.02-1.41). There were no sex differences in
hemoglobin A1c testing, microalbuminuria screening, or
angiotensin-converting enzyme inhibitor use. Women were less likely to report regular exercise but had better adherence to healthy diet,
glucose monitoring, and self-foot examination compared to men. Patterns of sex differences were consistent in subjects with
diabetic complications. Significant sex disparities exist in diabetes process of care measures and self-care, even amongst patients known to have chronic
diabetic complications.