Women with Type 1 Diabetes Twice as Likely as Men to Die from Heart Disease

Woman and Man WalkingWomen with type 1 diabetes have an increased excess risk of death from all causes and an increased excess risk of death from heart disease than men with type 1 diabetes, says a large meta-analysis of more than 200,000 participants recently published in the journal The Lancet Diabetes & Endocrinology.

Type 1 diabetes is a chronic disease characterized by high levels of glucose in the blood that usually begins during childhood or early adulthood. Approximately 15,000 children and 15,000 adults receive with type 1 diabetes diagnoses anuually in the United States, resulting in $14.9 billion in healthcare costs each year. Symptoms include frequent urination, increased thirst, dry mouth, increased hunger, fatigue, and weight loss. Untreated type 1 diabetes can cause cardiovascular disease, diabetic neuropathy, and diabetic retinopathy.

For the present study, researchers from the School of Public Health at The University of Queensland in Australia analyzed 26 studies between 1966 and 2014 that involved 214,114 participants with type 1 diabetes to examine sex-specific estimates of type 1 diabetes mortality.

The researchers found that women with type 1 diabetes had a 37 percent higher excess risk of death from any cause compared to men with the disease. Women with type 1 diabetes also had nearly twice the risk of dying from cardiovascular disease than men with the disease as well as a 37 percent increased risk of stroke and a 44 percent increased risk of death from kidney disease.

Explains lead author Rachel Huxley, professor in the School of Public Health at The University of Queensland in Australia:

“We know that people with type 1 diabetes have shorter life expectancies than the general population, from both acute and long-term diabetic complications. But, until now, it was not clear whether this excess risk of mortality is the same in women and men with the disease.

“On average, women live longer than men. But, our findings show that in women with type 1 diabetes this ‘female protection’ seems to be lost and excess deaths in women with type 1 diabetes are higher than in men with the disease.”

The researchers hypothesize that that poorer glycaemic control and difficulties in insulin management, which are more common among women, could contribute to the increased risk of vascular-related death in women with type 1 diabetes compared to men with the disease.

Comments Professor Huxley:

“The marked difference between the sexes for vascular-related disease is likely to have profound clinical implications for how women with type 1 diabetes are treated and managed throughout their lives. A recent joint statement issued by the American Heart Association and the American Diabetes Association concluded that further research into racial and ethnic differences and improved cardiovascular risk-prediction methods in people with type 1 diabetes is needed. In light of our findings, we argue that this statement should be extended to include sex differences.”

Adds David Simmons from the University of Western Sydney, New South Wales, Australia, in a linked comment:

“A key question is how the risk of excess mortality in women can be reduced further — a particular challenge given that the reasons for excess mortality in type 1 diabetes are still unclear. Reducing the high type 1 diabetes mortality rates will need additional expenditure on the care of patients with the disorder, many of the benefits from which might not be seen for up to 20 years. The additional investment in the diabetes specialist and mental health services to be able to give the additional time that patients need, and into modern technology that can help reduce hyperglycaemia while avoiding hypoglycaemia and fear of hypoglycaemia, must start now.”

Another recent study found that higher whole grain consumption may reduce the risk of total mortality as well as the risk of death resulting from cardiovascular disease.


Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis:
Women with type 1 diabetes at significantly higher risk of dying compared with men:
Women with type 1 diabetes ‘twice as likely’ as men to die from heart disease:

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