Type 1 Diabetes Linked to Higher Mortality, With Greater Relative Risk in Females

A retrospective cohort study in Diabetes Care assessed all-cause mortality among people diagnosed with type 1 diabetes before age 35 between 2000 and 2022. Investigators used a validated Maccabi Healthcare Services registry to identify 4,299 patients and matched them to 17,196 diabetes-free controls using 1:4 propensity score matching by sex and age. Follow-up continued until 2023, death, or departure from the network.

Across 204,102 person-years, 112 deaths occurred. Mortality rates were 131.0 per 100,000 person-years in the diabetes cohort versus 35.2 in controls, corresponding to a hazard ratio (HR) of 3.66 (95% CI 2.53–5.31). The adjusted relative mortality association was greater in females (HR 8.40; 95% CI 3.71–19.04) than males (HR 2.90; 95% CI 1.78–4.72; interaction P=0.02), despite higher absolute mortality rates in males.

With follow-up truncated for comparability, adjusted HRs were 4.36 for those diagnosed in 2000–2010 and 2.94 for those diagnosed in 2011–2022. These findings highlight persistent excess mortality and sex-specific differences in relative risk. However, the observational design cannot establish causes or attribute the lower estimate in recent years to advances in care. Confidence intervals for subgroup estimates were wide, and only the abstract was available for assessment.