Men with diabetes are too macho to follow diet and exercise regime, study finds

by Barbara Hewitt on December 1, 2015

Men are more likely to die from type 2 diabetes because they are less likely to follow diet and exercise recommendations, new research has found.

Put quite simply, men regard themselves as too macho to follow tailored diet and exercise regimes provided by health care teams, according to the study by researchers at the University of Copenhagen in Denmark.

Diabetes ManThey found that women given specific treatment plans were 30% less likely to die from diabetes-related causes than those given routine care and part of this was due to a very different attitude to change.

Structured personal diabetes care has long been advocated for people with the condition, with diet and exercise worked out for each patient. But women are more willing to take change on board.

“Women accept disease and implement disease management more easily, which might affect long-term outcomes,” said Dr. Marlene Krag, of the University of Copenhagen, adding that structured diabetes care goes against “men’s tendency to trust self-directed learning instead of self-management.”

The trait was found during a follow up to work done between 1989 and 1995. This original Diabetes Care in General Practice trial (Denmark) looked at structured personal care in patients newly diagnosed with type 2 diabetes.

In the intervention group, 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. GPs in the routine care 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 pre-defined non-fatal outcomes. However, the observed effect of structured personal care on reducing glycated haemoglobin (HbA1c), a standard method for measuring blood glucose control, measured six years after diagnosis was present only in women.

In this new study, the authors followed up the participants of the original study for 13 years from 1995 to 2008 with 970 out of the original 1,381 patients who survived and were re-examined at the end of six years of intervention in 1995. Of these, 478 were women and 492 were men.

The data to the end of 2008 showed that women given structured personal care were 26% less likely to die of any cause and 30% less likely to die of a diabetes-related cause than women given routine care. Women given the personal care intervention were also 41% less likely to suffer a stroke, and 35% less likely to experience any diabetes related endpoint.

None of these differences were seen between the personal care and routine care points in men, but the differences between genders were only statistically significant for all-cause mortality and diabetes-related death.

“Structured personal diabetes care could provide women with significant attention and support and thus provide an incentive to treatment adherence,” the study report says. “Masculinity may be challenged by diabetes, demanding daily consideration and lifestyle changes. The structured approach could conflict with men’s tendency to trust self-directed learning instead of self-management.

“We propose that the improved outcomes in women may be explained by complex social and cultural issues of gender. There is a need to further explore the gender specific effects of major intervention trials in order to rethink the way we provide medical care to both men and women, so that both sexes benefit from intensified treatment efforts.”

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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