Heart disease kills more people in the developed world than any other condition. In America, about 1 in 5 women will die of heart disease while men succumb to the disease at a rate of about 1 in 4.

Despite the fact that heart disease affects men at a greater rate and typically strikes males at a younger age, a new meta-analysis has found that women with diabetes are much more likely to suffer from heart conditions and artery blockages than men with diabetes.

There is no straightforward answer to why women with diabetes, and women with type 1 diabetic, in particular, are at higher risk than the general population. That said, there are some steps you can take to protect yourself from becoming a statistic.

Disheartening Findings of New Meta-Analysis

The study, published in Diabetologia, looked at the data of over 12 million diabetics published in various PubMed studies. Their goal was to compare the rates of heart disease and heart-related deaths between the sexes. They also kept track of diabetes type.

They found that type 1 women have a 47% greater excess risk of heart failure than type 1 men. Type 2 women are also at increased risk compared to their male counterparts, but only at about 9% greater excess risk.

Compared to non-diabetic women: T1D women were five times more likely to suffer from heart failure while T2D women were twice as likely to develop heart failure than non-diabetic women.

While the average first heart attack for males happens around age 66, women typically do not have their first heart attack until about 72. However, this “age protection” does not appear to apply to diabetic women, who are more likely to have a heart attack at a younger age than the general population.

Overall, there was a clear indication that heart disease disproportionately affects diabetic women, with type 1s being at the greatest risk.

Why Is Heart Disease So Prevalent in T1D Women?

This study did not provide an answer as to why this disparity exists between T1D women and T1D men.

We do know from previous data that diabetic women have a significantly greater risk of developing coronary heart disease, stroke, dementia, and cancer than diabetic men. While this information certainly makes the study findings less surprising, it does little to answer the question of why women seem so much more prone to cardiovascular complications of diabetes.

One potential reason for the higher heart disease in women may lie in the differences between how men and women store fat. 

Women typically store fat around the midsection, something that has been historically associated with higher cholesterol and other markers for cardiovascular disease. Since diabetes itself is also associated with less favorable blood lipid values (see Insulin Pumps may be the Ticket to Better Cholesterol), these factors may work together to exponentially increase heart disease risk in women.

There is also evidence that diabetic women receive delayed diagnosis, less intense care, and experience poorer glycemic control than men. The researchers were quick to point out that women experience two years longer duration on average of prediabetes compared to men. This prolonged exposure to elevated blood sugars could account for greater initial vascular damage. But this factor would only help explain the data seen in type 2 diabetics, as type 1s do not typically suffer through long periods of prediabetes.

Women Need to Take Additional Steps to Reduce Their Risk

Even if this new data doesn’t do much to explain why women are at such an increased risk of diabetes-related heart complications, it certainly does provide a dire warning about the importance of heart health for us diabetic females.

I recently wrote an article focusing on the importance of heart health for diabetics. In it are five tips to reduce your risk of CVD. While these steps seem more important than ever if you are a woman, there are some additional tips worth considering that are specific to females.

Atypical symptoms and delayed treatment

Women, in general, are more likely to have atypical symptoms of heart failure and heart attack than men.

Even worse, the average woman will wait 54 hours to seek treatment for heart attack compared to only 16 hours for men.

This may be one reason that the survival rate of men with heart disease is so much greater than women. In fact, only 36% of men will die within five years of their first heart attack while 47% of women will.

While these numbers are not specific to diabetics, they do shed some much-needed light on the existing disparities between men and women with heart disease.

Become your best advocate

As someone who is at increased risk of suffering from one of these episodes, it is extremely important that you educate yourself on the symptoms of a heart attack and how these can be different for women. And, since there is mounting evidence that the healthcare system fails more often with women than with men to diagnose and treat women suffering from heart failure, it is especially important that you advocate for yourself. 

There is also evidence that the same lack of care exists for women with diabetes. So the same advice is true for working with your endocrinologist to assure your blood sugars are under the tightest control they can be.

Avoid stress

Lastly, multiple studies looking at stress have found that women are affected much more negatively by household stress than men. 

Since stress has a known negative impact on heart health and blood pressure, it is even more important for diabetic women to find useful and consistent ways to cope with their stress.

Recognize your risk

While it may be frustrating to see studies like this that present such dire data without any real substance as to why that data exists, the message of this meta-analysis is still an important one. 

While we may not know for sure why this disparity exists, know that as a woman with diabetes, there are still steps you can and should take that will decrease your risk of heart disease.