Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood

Abstract

Conclusions: Worse glycaemic control was found in adolescent females, and they had a higher frequency of microvascular complications. Improved paediatric diabetes care is of great importance for increasing the likelihood of lower mortality and morbidity later in life.

Adolescent life with diabetes-Gender matters for level of distress. Experiences from the national TODS study

“…Our findings cannot explain why girls have higher HbA1c, lower BMI, and lower pH at diagnosis than boys . On the other hand, the findings can perhaps to some extent explain why females have worse metabolic control during adolescence than males . Females were also more often smokers than males during adolescence, which also made the metabolic control worse and will increase the risk for future vascular complications .…”

“…Gender matters even for the youngest children with diabetes. It has been shown that both the metabolic control at onset and further on and the degree of physical activity is less favorable for girls in comparison to boys . The hormonal changes during puberty make diabetes management even more difficult to handle, and this period of life is critical as an accelerator for diabetes complications .…”

“…It has been shown that females have worse metabolic control during adolescence than do boys . Samuelsson et al also have shown that, besides worse metabolic control, females have a higher frequency of microvascular complications as young adults. They also have higher incidence of diabetic ketoacidosis (DKA), dyslipidemia, and weight problems …”

Sex as a determinant of type 1 diabetes at diagnosis

“…A sex‐dependent difference in metabolic control has been shown in follow‐up studies, with female patients having poorer glycemic control and higher need for exogenous insulin, especially during adolescence . This finding has been considered somewhat surprising, as usually girls are more conscientious than boys.…”

“…It has been speculated that sex‐specific hormonal changes during puberty might provide an explanation for these differences, possibly due to increased growth hormone (GH) secretion in girls . Another explanation might be that girls are suffering from depression and psychological problems more often than boys . The glycemic control at the time of diagnosis has also been compared between sexes with the results suggesting that female patients have a higher glycated hemoglobin (HbA1c) level at diagnosis than male patients .…”