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Not enough men in Alberta – especially those in their 40s – are getting tested for diabetes, putting them at risk for heart disease, cancer and other illnesses, according to new population health research published in The Lancet Regional Health – Americas.

Padma Kaul

Padma Kaul

“My main message to young men is that early diagnosis is critical because diabetes is a huge risk factor for further complications,” says lead investigator Padma Kaul, professor of medicine at the University of Alberta and member of the Alberta Diabetes Institute and Canadian Institutes of Health Research Sex and Gender Science Chair.

Almost half of adults with diabetes remain undiagnosed, the researchers report. Having diabetes doubles the risk of also developing cardiovascular disease and is associated with an increased risk of developing some kinds of cancer, according to Diabetes Canada.

When it is caught early as “pre-diabetes,” changes to diet and exercise can prevent the development of full-fledged diabetes, says Kaul, who is also co-director of the Canadian VIGOUR Centre and Heart & Stroke Chair in Cardiovascular Research.

Diabetes Canada screening guidelines recommend that everyone over 40 gets screened for diabetes at least once every three years. Various tests can be used to check blood sugar levels.

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The researchers used data from Alberta’s public healthcare system to track diabetes screening rates in 1.4 million patients for three years starting in April 2013. Those screened for diabetes were then followed for an additional four years to see how many were diagnosed with either diabetes or pre-diabetes. People who already had diabetes or heart disease were excluded because the screening protocols are different for them.

The sex difference was most striking in the 40-to-45 age range: 58 percent of males were screened within the recommended time frame compared with 72.6 percent of females.

Overall, just under 79.8 percent of females and 69.9 percent of males were screened. The researchers found that those differences were consistent between urban and rural settings and among different socioeconomic groups. The differences disappeared in people over 65.

Though males were less likely to get tested, they had a higher risk of developing diabetes. Among those screened, 15.7 percent of males were found to have pre-diabetes and 2.6 percent had diabetes, while the rates were 13.4 percent and 1.5 percent respectively among females.

Diabetes screening in Alberta is usually initiated by a family physician with a lab requisition. Kaul says previous studies have shown that women are more likely to go for annual physicals. She wonders whether screening should be offered in non-traditional settings such as gyms or workplaces to help raise awareness.

“There have been public health campaigns to make women more aware of heart disease, for example, and they’ve been really effective, so now we need campaigns directed at men – and especially young men – for diabetes screening,” says Kaul, who is also an adjunct professor with the U of A’s School of Public Health and Duke University’s Population Health Sciences department.

“I’m actually quite pleased with how high the screening rates are overall, but we are missing this really focused segment of the population and we need to improve matters,” Kaul says.

This paper is the first to be published from a four-year project called the Real-world Evidence on the association between DIabetes and Sex on CardiOVascular Event Rates (REDISCOVER) Study. The same research team will next look for sex differences in how diabetes affects the development of heart disease. They will also assess the risk of cardiovascular disease associated with pre-diabetes in both men and women.

| By Gillian Rutherford

Gillian is a reporter with the University of Alberta’s Folio online magazine. The University of Alberta is a Troy Media Editorial Content Provider Partner.

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