: The current study was to evaluate risk factors and atherosclerotic cardiovascular disease (ASCVD) among diabetic patients by sex.: Patients with type 2 diabetes mellitus were enrolled, and baseline characteristics and prevalent ASCVD (including coronary heart disease [CHD], ischemic stroke [IS], and peripheral vascular disease [PVD]) were collected and compared by sex.: Females accounted for 48.5% (n = 284) of the current study. Compared to males, females had a longer duration of diabetes mellitus (9.1 ± 4.0 vs 8.0 ± 3.7 years), and were more likely to be obese (38% vs 34.4%), have hypertension (49.3% vs 45.7%) and have a lower estimated glomerular filtration rate (75.0 ± 20.6 vs 77.4 ± 19.2 ml/min/1.73 m). Females were less likely to smoke (2.8% vs 31.1%), and receive anti-platelets (53.5% vs 56%), angiotensin converting enzyme inhibitor/angiotensin receptor blocker (31.7% vs 35.1%), and metformin (81.7% vs 85.4%). Females had a higher prevalence of CHD (9.9% vs 8.6%) and composite ASCVD (21.8% vs 18.9%). After adjustment for potential covariates, female sex remained independently associated with composite ASCVD (odds ratio [OR]: 1.21 and 95% confidence interval [CI]: 1.05-1.57) and CHD (OR: 1.13 and 95% CI: 1.01-1.38).: Among diabetic people, compared to males, females had a higher comorbid burden but received less optimal treatment, which might partly explain their higher prevalence of composite ASCVD and CHD.

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