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Middle-aged woman reading

A study in The Lancet Diabetes & Endocrinology of nearly 1 million adults from 68 prospective studies around the world found that women with diabetes are about five times more likely to die of a heart attack or stroke before the age of 70 than women without diabetes, suggesting that around 80% of deaths in women with diabetes are caused directly by the disease. For men, although diabetes increases the risk of death, the risk is only about two to three times higher than in non-diabetic men. Consequently, diabetes seems to cancel out the female advantage (whereby women have lower heart attack and stroke rates than similarly-aged men) so that the rate at which women with diabetes suffered a fatal heart attack or stroke was almost the same as the rate among similarly aged men without diabetes.

Senior author Associate Professor Sarah Lewington from the MRC Population Health Research Unit, who leads the Prospective Studies Collaboration, said: “While diabetes is an important cause of premature death from heart attack or stroke in both men and women, it seems to pose a particularly high risk for middle-aged women. But these vascular risks can be greatly reduced by inexpensive drugs that control blood sugar, blood pressure and cholesterol.”

In a comment piece in the same issue Anna Norhammar from the Karolinska Institutet, Sweden said “Lewington and colleagues have helped to highlight that sex remains an important factor in the assessment of cardiovascular risk in patients with diabetes.”