Massive analysis shows diabetes may be bigger danger to women’s hearts

Professor Rachel Huxley,
University of Queensland 

DIABETES DIGEST – May 27, 2014 – One of the things about participating in a clinical trial is that it is a gift that keeps on giving. Such is the case of a new study out this week that included data from people who participated in diabetes trials nearly 50 years ago. Data from those people added to others through the years keeps adding to researchers’ understanding of how damaging diabetes is. The result of the new investigation shows that women with type 2 diabetes appear to be at a much greater risk of heart disease than previously thought. 

The new Australian analysis of 64 past studies involving more than 850,000 participants found that women with diabetes had a 40 percent to 50 percent greater risk of heart disease than men.

Led by Professor Rachel Huxley, School of Population Health, University of Queensland, Australia, the researchers looked at data from studies spanning 1966 to 2011. They found a total of 28,203 heart-related events, and that women with diabetes had almost three times the risk of heart disease compared to women without diabetes, and that men with diabetes were a little more than twice as likely to have heart disease as men without the disease. 

When they combined the two sets of data they found that women with diabetes were 44 percent more likely to develop heart disease than men with diabetes even after considerations were factored in for sex differences in other coronary heart disease characteristics. When they looked at the risk of dying from heart disease related to diabetes, they found that women had a 46 percent increased risk of dying from coronary heart disease compared to men. 

In addition, the risk of stroke was also higher. “Our analysis of the data showed, in comparison to men with diabetes,” Huxley said in a press release, “women with the condition had a 27 per cent higher relative risk of stroke even after taking into account other risk factors such as age and blood pressure.”

While the study didn’t differentiate between type 1 and type 2 diabetes, more than 90 percent of people with diabetes have type 2 according to the World Health Organization. The study was published online May 22, 2014 by Diabetologia (the journal of the European Association for the Study of Diabetes. It was previously published in the Lancet in March).

The researchers said that their study did not look at why there should be such a big gap between men and women in terms of diabetes and heart disease risks, but they did compare some of the findings of the early studies versus the newer studies. That comparison suggested that women tend to develop type 2 diabetes later than men, specifically, when they are at a higher body mass index (BMI) than men. As a result they tend to also have worse cardiovascular health by the time they are diagnosed with diabetes. 

"If confirmed, the implementation of sex-specific interventions before diabetes becomes manifest,” the researchers said in a press release, “such as increased screening for prediabetes, especially in women, combined with more stringent follow-up of women at high risk for diabetes, such as women with a history of gestational diabetes – could have a substantial impact on the prevention of coronary heart disease."