Women with type 1 diabetes at significantly higher risk of dying compared with men

February 6, 2015, Lancet

Women with type 1 diabetes face a 40% increased excess risk of death from all causes, and have more than twice the risk of dying from heart disease, compared to men with type 1 diabetes, a large meta-analysis involving more than 200 000 people with type 1 diabetes published in The Lancet Diabetes & Endocrinology has found.

"We know that people with 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 and men with the disease", explains Rachel Huxley, lead author and Professor in the School of Public Health at The University of Queensland in Australia.

"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."

Huxley and colleagues conducted a meta-analysis of all studies examining sex-specific estimates of mortality for men and women associated with type 1 diabetes spanning the last five decades (January 1966 to November 2014).

Analysis of data from 26 studies involving 214 114 individuals with the disease found a 37% higher excess risk of dying from any cause in women with type 1 diabetes compared with men who have the disorder. In particular, women have nearly double the excess risk of developing or dying from cardiovascular disease than men. Women with type 1 diabetes also face a greater excess risk of strokes (37%) and are 44% more likely to die from kidney disease than men with the disorder. Interestingly, type 1 diabetes is not linked with an increased risk of death from cancers in either sex.

The authors speculate that poorer glycaemic control and difficulties in insulin management, which are more common among women, could be contributing factors to the increased risk of vascular-related death in women with type 1 diabetes compared with men with the condition.

According to 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."

Type 1 diabetes is on the rise. Worldwide, the incidence of type 1 diabetes in children aged 14 years and younger has increased by 3% every year since 1989. Around 15 000 children and 15 000 adults are diagnosed with type 1 diabetes each year in the USA alone, and the disease costs the US health-care system around US$14.9 billion annually.

Writing in a linked Comment, David Simmons from the University of Western Sydney, New South Wales, Australia says, "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 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."

Explore further: Study finds substantially shorter life expectancy for patients with type 1 diabetes

Related Stories

Study finds substantially shorter life expectancy for patients with type 1 diabetes

January 6, 2015
For patients with type 1 diabetes in Scotland, at age 20 years, the average man has an estimated life expectancy loss of about 11 years; for women, it is 13 years, compared with the general Scottish population without type ...

Two in five Americans at risk from type 2 diabetes, study finds

August 12, 2014
Two in five American adults are expected to develop type 2 diabetes in their lifetime, according to a study published Tuesday that warned of spiralling health costs as a result.

Women with diabetes 44 percent more likely to develop coronary heart disease than men

May 22, 2014
A systematic review and meta-analysis of some 850,000 people published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that women with diabetes are 44% more likely to develop coronary ...

A simple method to monitor beta-cell death in individuals at-risk for type 1 diabetes

February 2, 2015
Type 1 diabetes is characterized by death and reduced function of β cells, which produce insulin. The presence of specific autoantibodies can identify individuals at risk of developing type 1 diabetes, and many of these ...

Job strain can raise risk of developing type 2 diabetes

August 4, 2014
(HealthDay)—Stress at work may increase the risk of developing type 2 diabetes, according to research published in the August issue of Diabetes Care.

PTSD doubles diabetes risk in women

January 7, 2015
Women with post-traumatic stress disorder are nearly twice as likely to develop type 2 diabetes compared with women who don't have PTSD, according to researchers at the Mailman School of Public Health at Columbia University ...

Recommended for you

Researchers cure type 2 diabetes and obesity in mice using gene therapy

July 10, 2018
A research team from the UAB led by Professor Fatima Bosch has managed to cure obesity and type 2 diabetes in mice using gene therapy.

Human clinical trial reveals verapamil as an effective type 1 diabetes therapy

July 9, 2018
Researchers at the University of Alabama at Birmingham Comprehensive Diabetes Center have discovered a safe and effective novel therapy to reduce insulin requirements and hypoglycemic episodes in adult subjects with recent ...

New targets found to reduce blood vessel damage in diabetes

July 9, 2018
In diabetes, both the tightly woven endothelial cells that line our blood vessels and the powerhouses that drive those cells start to come apart as early steps in the destruction of our vasculature.

Insurance gaps linked to five-fold rise in hospital stays for adults with type 1 diabetes

July 9, 2018
For a million American adults, living with type 1 diabetes means a constant need for insulin medication, blood sugar testing supplies and specialized care, to keep them healthy and prevent a crisis that could end up in an ...

Abnormal branched-chain amino acid breakdown may raise diabetes risk

July 5, 2018
In the U.S., about five out of 100 expectant mothers develop gestational diabetes mellitus (GDM), a temporary form of diabetes in which hormonal changes disrupt insulin function. Although GDM is often symptomless and subsides ...

Air pollution contributes significantly to diabetes globally

June 30, 2018
New research links outdoor air pollution—even at levels deemed safe—to an increased risk of diabetes globally, according to a study from Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.