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Glucose Management and the Sex Difference in Excess Cardiovascular Disease Risk in Long-Duration Type 1 Diabetes

  • Lifestyle Management to Reduce Diabetes/Cardiovascular Risk (B Conway and H Keenan, Section Editors)
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Abstract

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.

Recent Findings

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.

Summary

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.

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  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 3512 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Rachel G. Miller & Tina Costacou

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Rachel G. Miller and Tina Costacou declare that they have no conflict of interest.

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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.

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Miller, R.G., Costacou, T. Glucose Management and the Sex Difference in Excess Cardiovascular Disease Risk in Long-Duration Type 1 Diabetes. Curr Diab Rep 19, 139 (2019). https://doi.org/10.1007/s11892-019-1240-4

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