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

12 February, 2015

The Lancet Diabetes and Endocrinology has published a review on a large meta-analysis involving more than 200,000 people with Type 1 diabetes. From this they have found that women with Type 1 diabetes are at a 40 per cent increased risk of death from all causes, and have more than twice the risk of dying from heart disease, compared with that of men with Type 1 diabetes.

The report says, “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 analysis was conducted as there have been studies that have suggested differences in mortality rates associated with Type 1 diabetes between men and women. Huxley and colleagues conducted the meta-analysis by systematically searching PubMed for all studies examining sex-specific estimates of mortality for men and women associated with Type 1 diabetes between 1966 and 2014.

“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”, explains Rachel Huxley, lead author and Professor in the School of Public Health at The University of Queensland in Australia.

Data from 26 studies involving 214,114 individuals with the disease was analysed and it was found that there is a 37 per cent higher excess risk of dying from any cause in women with Type 1 diabetes compared with men who have Type 1 diabetes. 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 37 per cent greater excess risk of strokes and are 44 per cent 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.

Simon O’Neill, Diabetes UK Director of Health Intelligence, commented on this: “This study highlights that women with Type 1 diabetes have a significantly higher risk of dying compared to their peers. The study also shows that women with Type 1 have a greater increased risk of death than men with Type 1 diabetes. The exact reasons behind this are not clear but there has been some evidence to suggest that changes to girls’ bodies during puberty can make it more difficult for them to get their diabetes under control."

"We also know that people with Type 1 diabetes, particularly younger people with the condition, are less likely to get their annual checks and have their condition under control than other people with diabetes, and this puts them at increased risk of life threatening complications, such as amputation, kidney failure and heart disease later in life, which are not only personally devastating but are also extremely costly to the NHS. This is why we need the NHS to urgently improve diabetes care so that all people are offered care that is tailored to their individual needs, and so are able to manage their condition effectively, and reduce their risk of devastating complications and early death. With the right care and support in place there is no reason why people with Type 1 diabetes – both men and women – can’t live long, healthy lives.”

Source:The Lancet article.

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