Risk of Mortality for Women and Men with Type 1 Diabetes

Australian researchers have had their research on mortality and vascular events in men and women with type 1 diabetes published in The Lancet Diabetes & Endocrinology.
The research shows that women with type 1 diabetes [1] face a 40 per cent increased excess risk of death from all causes [2], and have more than twice the risk of dying from heart disease, compared to men with type 1 diabetes.
The results were determined after conducting a conducted a meta-analysis of more than 200,0000 people with type 1 diabetes in 26 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).
Lead author Professor Rachel Huxley from the School of Public Health at The University of Queensland, said while it is known that  people with type 1 diabetes have shorter life expectancies than the general population, from both acute and long-term diabetic complications, it is only now that they have determined the excess risk of mortality is the not same in women and men with the disease.[3]
“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.”[3]
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.”[3]
David Simmons from the University of Western Sydney, New South Wales, 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 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,” he adds.