BMJ 2015;350:h678 doi: 10.1136/bmj.h678 (Published 6 February 2015)
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Research News
RESEARCH NEWS Women with type 1 diabetes have significantly higher risk of dying than men Zosia Kmietowicz The BMJ
Women with type 1 diabetes are at raised risk of dying from any cause and twice as likely to die from heart disease as men with type 1 diabetes, a meta-analysis has found.1
It is well known that people with type 1 diabetes have a shorter life expectancy than the general population. “But, until now, it was not clear whether this excess risk of mortality is the same in women and men with the disease,” said Rachel Huxley, lead author of the study and professor in the School of Public Health at the University of Queensland, Australia. To investigate whether a gender difference exists in mortality associated with type 1 diabetes the researchers analysed data from 26 studies involving 214 114 people with the disease. Their results, published in the Lancet Diabetes and Endocrinology, showed that that women with type 1 diabetes have a higher excess all cause mortality than men (ratio of standardised mortality ratio 1.37 (95% confidence interval 1.21 to 1.56)) and higher excess mortality from stroke (1.37 (1.03 to 1.81)), coronary heart disease (2.54 (1.80 to 3.60)), cardiovascular disease (1.86 (1.62 to 2.15)), and renal disease (1.44 (1.02 to 2.05)). The authors speculated 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 when compared with men who have the condition.
Writing in a linked comment David Simmons, of the University of Western Sydney, New South Wales, said that one of the challenges was to reduce the excess mortality among women with type 1 diabetes while the reasons for it are not yet clear.2
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He said, “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.”
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Huxley HR, Peters SAE, Mishra GD, Woodward M. Risk of all cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015. http://dx.doi.org/10.1016/ S2213-8587(14)70248-7. Simmons D. Excess death in women with type 1 diabetes: time to act. Lancet Diabetes Endocrinol 2015. http://dx.doi.org/10.1016/ S2213-8587(14)70272-4.
Cite this as: BMJ 2015;350:h678 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Research News
RESEARCH NEWS Women with type 1 diabetes have significantly higher risk of dying than men Zosia Kmietowicz The BMJ
Women with type 1 diabetes are at raised risk of dying from any cause and twice as likely to die from heart disease as men with type 1 diabetes, a meta-analysis has found.1
It is well known that people with type 1 diabetes have a shorter life expectancy than the general population. “But, until now, it was not clear whether this excess risk of mortality is the same in women and men with the disease,” said Rachel Huxley, lead author of the study and professor in the School of Public Health at the University of Queensland, Australia. To investigate whether a gender difference exists in mortality associated with type 1 diabetes the researchers analysed data from 26 studies involving 214 114 people with the disease. Their results, published in the Lancet Diabetes and Endocrinology, showed that that women with type 1 diabetes have a higher excess all cause mortality than men (ratio of standardised mortality ratio 1.37 (95% confidence interval 1.21 to 1.56)) and higher excess mortality from stroke (1.37 (1.03 to 1.81)), coronary heart disease (2.54 (1.80 to 3.60)), cardiovascular disease (1.86 (1.62 to 2.15)), and renal disease (1.44 (1.02 to 2.05)). The authors speculated 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 when compared with men who have the condition.
Writing in a linked comment David Simmons, of the University of Western Sydney, New South Wales, said that one of the challenges was to reduce the excess mortality among women with type 1 diabetes while the reasons for it are not yet clear.2
For personal use only: See rights and reprints http://www.bmj.com/permissions
He said, “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.”
1 2
Huxley HR, Peters SAE, Mishra GD, Woodward M. Risk of all cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015. http://dx.doi.org/10.1016/ S2213-8587(14)70248-7. Simmons D. Excess death in women with type 1 diabetes: time to act. Lancet Diabetes Endocrinol 2015. http://dx.doi.org/10.1016/ S2213-8587(14)70272-4.
Cite this as: BMJ 2015;350:h678 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
