Glucose Management and the Sex Difference in Excess Cardiovascular Disease Risk in Long-Duration Type 1 Diabetes
Purpose of Review
The protection against CVD observed in women compared to men in the general population is essentially erased in type 1 diabetes. This review will discuss evidence regarding the role of glucose management on CVD risk by sex, with a particular focus on studies of long-duration type 1 diabetes of > 20 years.
Across studies, women with type 1 diabetes have similar or worse glycemic control compared to men, despite higher rates of intensive insulin therapy. The association between HbA1c and CVD risk does not seem to differ by sex, but few studies have reported on sex-specific analyses.
Beyond HbA1c, there is a lack of published data regarding the relationship between other aspects of glucose management and CVD risk by sex in type 1 diabetes. Glucose management factors do not seem to directly account for the increased CVD risk in women with type 1 diabetes, but may influence other risk factors that play a more direct role.
KeywordsType 1 diabetes Sex differences Glucose management Glycemic control Diabetes management Cardiovascular disease
Compliance with Ethical Standards
Conflict of Interest
Rachel G. Miller and Tina Costacou declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
Research protocols for the EDC study were approved by the University of Pittsburgh Institutional Review Board, and all participants provided written informed consent. This article does not contain any studies with animal subjects performed by the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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