T1DM Confers Greater Risk of HF in Women than Men

Pavankumar Kamat


April 29, 2021


  • Women with diabetes, especially those with type 1 diabetes mellitus (T1DM), had an increased risk of heart failure (HF) than men with diabetes.

  • The increased risk cannot be explained solely by the higher prevalence of coronary artery disease and other cardiac risk factors.

Why this matters

  • Findings suggest that diabetic cardiomyopathy, an independent factor may be potentially driving the excess risk of HF in women with diabetes.

Study design

  • A study of 493,167 participants from the UK Biobank study.

  • The risks of mortality and incident HF with a median follow-up of 9 and 8 years, respectively, were evaluated.

  • Funding: European Union’s Horizon 2020 research and others.

Key results

  • Overall, 22,685 (4.6%) participants had prevalent diabetes (T1DM, 2626; type 2 diabetes mellitus [T2DM], 20,059).

  • Of these, 2454 died and 1223 were diagnosed or admitted with HF during the follow-up of 9 and 8 years, respectively.

  • The risks of mortality (adjusted HR [aHR], 1.9; 95% CI, 1.8-2.0) and HF (aHR, 1.9; 95% CI, 1.8-2.1) were almost doubled in patients with diabetes vs those without.

  • Women vs men with diabetes (T1DM and T2DM) had an increased risk of HF (aHR, 2.2; 95% CI, 1.9-2.5 vs 1.8; 95% CI, 1.7-2.0; Pinteraction=.007).

  • The risk of HF increased by:

    • 88% in women vs men with T1DM (aHR, 4.7; 95% CI, 3.6-6.2 vs 2.5; 95% CI, 2.0-3.0; Pinteraction=.0001); and

    • 17% in women vs men with T2DM (aHR, 2.0; 95% CI, 1.7-2.3 vs 1.7; 95% CI, 1.6-1.9; Pinteraction=.10).

  • The risk of HF remained high in women with T1DM after accounting for the effect of mortality as a competing risk.


  • Glycated haemoglobin measurement at enrolment does not reflect long-term glycaemic control.


Chadalavada S, Jensen MT, Aung N, Cooper J, Lekadir K, Munroe PB, Petersen SE. Women With Diabetes Are at Increased Relative Risk of Heart Failure Compared to Men: Insights From UK Biobank. Front Cardiovasc Med. 2021;8:658726. doi: 10.3389/fcvm.2021.658726. PMID: 33889602. View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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