Heart Failure Associated with Diabetes More Common in Women than Men

With diabetes continuing to grow as a global issue, new data on the disease’s impact, specifically on risk factors for other conditions, can have a profound impact on clinical practice.

Results of a recent study could do just that, as investigators carried out a global study that included more than 12 million participants and found that the risk of heart failure (HF) associated with diabetes was greater in women than in men. 



"It is already known that diabetes puts you at greater risk of developing heart failure but what our study shows for the first time is that women are at far greater risk - for both type 1 and type 2 diabetes," said lead investigator Toshiaki Ohkuma, PhD, of the George Institute. 



Investigators sought to evaluate whether associations between risk of HF in diabetic patients was the same among men and women. The current meta-analysis is a systematic review of population based studies published between Jan. 1966 and Nov. 2018.

Data included participants from 10 counties including Australia, the United States, the United Kingdom, Italy, China, and Taiwan amongst others.

To be included, studies had to be observational cohort studies and needed to provide sex-specific risk ratios (RR) or equivalents. Studies that only reported data for a single sex, did not adjust for age, or did not provide information about the variability of point estimate were excluded. Investigators identified studies through a systematic search in PubMed in Nov. 2018.

From their search, a total of 5991 articles were identified and 760 of them qualified for full-text evaluation. A group of 14 articles, all of which provided summary data for sex differences in the association between diabetes and risk of HF, were chosen for the current study.

The 14 articles chosen contained 11,925,128 individuals who experienced a total of 249,560 events. In a pooled, multivariable-adjusted analysis, investigators found that the RR for HF associated with type 1 diabetes was 5.15 (95% CI 3.43, 7.74) in women and 3.47 (2.57, 4.69) in men — this corresponded with a ratio of RR of 1.47 (1.44, 1.90). 


For type 2 diabetes, the pooled RRs for HF associated with type 2 drab tees were 1.95 in women and 1.74 in men. This corresponded with a pooled RRR of 1.09.

"Women were reported to have two years' longer duration of prediabetes than men and this increased duration may be associated with greater excess risk of heart failure in women" said Sanne Peters, PhD, of the George Institute. "Some major concerns are that women are also being undertreated for diabetes, are not taking the same levels of medications as men and are less likely to receive intensive care."



This study, titled “Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals,” is published in Diabetologia.