Gender Differences in Diabetes-related Lower Extremity... : Clinical Orthopaedics and Related Research® (original) (raw)
Symposium: AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium
1 Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S Maryland Avenue MC 2007, 60637, Chicago, IL, USA
2 Diabetes Research and Training Center, University of Chicago, Chicago, IL, USA
3 Center for Health and the Social Sciences, University of Chicago, Chicago, IL, USA
a e-mail; [email protected]
Dr. Peek has received funding from the Robert Wood Johnson Foundation, Harold Amos Medical Faculty Development program, and the Mentored Patient-Oriented Career Development Award of the National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK075006).
Abstract
Background
Diabetes is a major cause of morbidity and mortality in the United States, with much of the economic and social costs related to macrovascular and microvascular complications, such as myocardial infarctions, renal failure, and lower extremity amputations. While racial/ethnic differences in diabetes are well documented, less attention has been given to differences in diabetes outcomes by gender.
Questions/purposes
Does gender influence the rate of diabetes-related lower extremity amputations and/or the rate of mortality after amputation?
Methods
I reviewed the literature utilizing peer-reviewed publications found through MEDLINE searches.
Where are we now?
Major complex gender differences exist in diabetes-related lower extremity amputations: men are more likely to undergo lower extremity amputations, but women apparently have higher mortality related to these procedures. The reasons for such differences are not entirely clear, but it appears biologic factors may play important roles (increased rates of peripheral vascular disease and peripheral neuropathy in men, interaction between gender and cardiac mortality in women).
Where do we need to go?
More research is warranted to confirm gender differences in diabetes-related lower extremity amputation mortality and explore underlying mechanisms for the gender differences in lower extremity amputations and its associated mortality.
How do we get there?
Exploring gender disparities in diabetes-related outcomes, such as lower extremity amputations, will need to become a national priority from a research (eg, National Institutes of Health) and policy (eg, Centers for Medicare and Medicaid Services) perspective. Only when we have a better understanding of the causes of such differences can we begin to make strides in addressing them.
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