Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis
© 2015 Elsevier Ltd. Background: Studies have suggested sex differences in the mortality rate associated with type 1 diabetes. We did a meta-analysis to provide reliable estimates of any sex differences in the effect of type 1 diabetes on risk of all-cause mortality and cause-specific outcomes. Meth...
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| Format: | Journal Article |
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2015
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| Online Access: | http://hdl.handle.net/20.500.11937/15312 |
| _version_ | 1848748859291860992 |
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| author | Huxley, Rachel Peters, S. Mishra, G. Woodward, M. |
| author_facet | Huxley, Rachel Peters, S. Mishra, G. Woodward, M. |
| author_sort | Huxley, Rachel |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2015 Elsevier Ltd. Background: Studies have suggested sex differences in the mortality rate associated with type 1 diabetes. We did a meta-analysis to provide reliable estimates of any sex differences in the effect of type 1 diabetes on risk of all-cause mortality and cause-specific outcomes. Methods: We systematically searched PubMed for studies published between Jan 1, 1966, and Nov 26, 2014. Selected studies reported sex-specific estimates of the standardised mortality ratio (SMR) or hazard ratios associated with type 1 diabetes, either for all-cause mortality or cause-specific outcomes. We used random effects meta-analyses with inverse variance weighting to obtain sex-specific SMRs and their pooled ratio (women to men) for all-cause mortality, for mortality from cardiovascular disease, renal disease, cancer, the combined outcome of accident and suicide, and from incident coronary heart disease and stroke associated with type 1 diabetes. Findings: Data from 26 studies including 214 114 individuals and 15 273 events were included. The pooled women-to-men ratio of the SMR for all-cause mortality was 1·37 (95% CI 1·21-1·56), for incident stroke 1·37 (1·03-1·81), for fatal renal disease 1·44 (1·02-2·05), and for fatal cardiovascular diseases 1·86 (1·62-2·15). For incident coronary heart disease the sex difference was more extreme; the pooled women-to-men ratio of the SMR was 2·54 (95% CI 1·80-3·60). No evidence suggested a sex difference for mortality associated with type 1 diabetes from cancer, or accident and suicide. Interpretation: Women with type 1 diabetes have a roughly 40% greater excess risk of all-cause mortality, and twice the excess risk of fatal and nonfatal vascular events, compared with men with type 1 diabetes. Funding: None. |
| first_indexed | 2025-11-14T07:11:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-15312 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:11:44Z |
| publishDate | 2015 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-153122017-09-13T13:41:02Z Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis Huxley, Rachel Peters, S. Mishra, G. Woodward, M. © 2015 Elsevier Ltd. Background: Studies have suggested sex differences in the mortality rate associated with type 1 diabetes. We did a meta-analysis to provide reliable estimates of any sex differences in the effect of type 1 diabetes on risk of all-cause mortality and cause-specific outcomes. Methods: We systematically searched PubMed for studies published between Jan 1, 1966, and Nov 26, 2014. Selected studies reported sex-specific estimates of the standardised mortality ratio (SMR) or hazard ratios associated with type 1 diabetes, either for all-cause mortality or cause-specific outcomes. We used random effects meta-analyses with inverse variance weighting to obtain sex-specific SMRs and their pooled ratio (women to men) for all-cause mortality, for mortality from cardiovascular disease, renal disease, cancer, the combined outcome of accident and suicide, and from incident coronary heart disease and stroke associated with type 1 diabetes. Findings: Data from 26 studies including 214 114 individuals and 15 273 events were included. The pooled women-to-men ratio of the SMR for all-cause mortality was 1·37 (95% CI 1·21-1·56), for incident stroke 1·37 (1·03-1·81), for fatal renal disease 1·44 (1·02-2·05), and for fatal cardiovascular diseases 1·86 (1·62-2·15). For incident coronary heart disease the sex difference was more extreme; the pooled women-to-men ratio of the SMR was 2·54 (95% CI 1·80-3·60). No evidence suggested a sex difference for mortality associated with type 1 diabetes from cancer, or accident and suicide. Interpretation: Women with type 1 diabetes have a roughly 40% greater excess risk of all-cause mortality, and twice the excess risk of fatal and nonfatal vascular events, compared with men with type 1 diabetes. Funding: None. 2015 Journal Article http://hdl.handle.net/20.500.11937/15312 10.1016/S2213-8587(14)70248-7 restricted |
| spellingShingle | Huxley, Rachel Peters, S. Mishra, G. Woodward, M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title | Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title_full | Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title_fullStr | Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title_full_unstemmed | Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title_short | Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: A systematic review and meta-analysis |
| title_sort | risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis |
| url | http://hdl.handle.net/20.500.11937/15312 |