New Study Highlights Sex and Type Differences in Cardiovascular Risks for Diabetes Patients

A comprehensive study presented at the European Association for the Study of Diabetes (EASD) 2025 meeting offers new insights into how cardiovascular disease (CVD) risk varies between men and women with type 1 diabetes (T1D) and type 2 diabetes (T2D). Conducted using a large Swedish national cohort, the research reveals that younger men with T2D face higher mortality and cardiovascular risks compared to those with T1D. Conversely, women of all ages with T1D tend to experience worse outcomes than their T2D counterparts.

The study analyzed data from over 404,000 diabetes patients aged 18–84 years, tracking occurrences of heart attack, heart failure, stroke, cardiovascular mortality, and all-cause mortality over five years. The findings showed that men under 50 with T2D had a 51% higher risk of overall CVD and more than double the risk of heart attack compared to T1D men. However, as age increased, the trend shifted: men with T1D had higher risks of cardiovascular events than those with T2D, especially after age 60.

Women with T2D over 50 consistently demonstrated lower risks of CVD and related outcomes compared to women with T1D. Notably, women aged 50–59 with T2D had 25% lower risk of CVD and 41% lower risk of heart attack than women with T1D. Similarly, in women over 70, risks were roughly 17-31% lower for T2D.

The researchers, led by Dr. Vagia Patsoukaki from Uppsala University, explain that early onset and longer disease duration in women with T1D contribute to their higher risk profile. Additionally, women with T1D often have less aggressive treatment and less protection from natural hormonal advantages, such as estrogen, which supports vascular health. Conversely, young men with T2D typically have more risk factors like obesity and hypertension, leading to worse outcomes.

After adjusting for common risk factors such as blood pressure, cholesterol, and kidney function, female sex remained protective overall, reducing the likelihood of CVD outcomes by approximately 35%. Nevertheless, the persistence of elevated risks in women with T1D underscores the importance of early, aggressive management of modifiable risks.

The study emphasizes that while biological differences influence cardiovascular outcomes, the clustering of risk factors in T2D makes it inherently more dangerous. The researchers also highlight the critical role of disease duration; longer exposure to hyperglycemia in T1D contributes significantly to the lifetime risk.

In conclusion, these findings underline the importance of personalized risk assessments based on sex and diabetes type to improve preventative strategies and treatment approaches, ultimately reducing CVD burden in these vulnerable populations.