Gender Distribution in Lipid-Lowering Treatment among People with Diabetes across Spanish Regions: 2020–2024 Analysis

Introduction and Objective: With over 5.1 million adults with diabetes in Spain (14.8% prevalence), optimizing cardiovascular prevention is critical. This study examines temporal trends and age-stratified patterns in lipid-lowering therapy utilization among diabetic patients from 2020 to 2024. Methods: Nationwide analysis of lipid-lowering treatment data in four age groups (0-14, 15-34, 35-64, ≥65 years), stratified by sex, using annual information from 19 Spanish regions. Trends were assessed across the COVID-19 pandemic and post-pandemic period. Results: Treatment coverage increased 15.2% over five years, from 3,440,254 to 3,962,928 cases. Elderly patients (≥65 years) represented 64% of treated individuals, rising 15.4% from 2,203,609 (2020) to 2,542,155 (2024). Middle-aged adults (35-64 years) grew 15.6%, from 1,155,014 to 1,334,477. Younger groups showed different patterns: those aged 15-34 increased modestly (68,732 to 86,354), while pediatric cases (0-14 years) rose from 12,898 to 14,950, likely reflecting increasing type 1 diabetes prevalence. Gender gaps were most evident in middle age (60.1% men vs. 39.9% women among 35-64-year-olds), whereas in older individuals differences narrowed (53.4% men vs. 46.6% women), suggesting later onset or delayed treatment in women.Regionally, treatment expansion mirrored baseline diabetes burden: high-prevalence regions such as the Canary Islands (9.72%) maintained high treatment rates; more moderate-prevalence regions such as Castilla y León (4.51%) showed proportionally lower but stable coverage. Conclusion: Spain shows robust and expanding lipid-lowering therapy coverage across all age groups, resilient to healthcare disruptions. Persistent gender disparities in middle-aged diabetic patients and underuse of earlier treatment in women highlight the need for targeted strategies to achieve equitable cardiovascular risk management. Disclosure: J. Ares Blanco: None. E.L. Menendez Torre: None.