Women with diabetes are almost twice as likely to suffer premature death, according to new research.
The metabolic disease shortens their lives by an average of five years - six months more than for male peers. This triples to 15 years - if she also smokes.
A ten-year study found a dramatic gender gap in mortality rates - 96 and 74 percent. Type 2 diabetes was assumed to have a greater effect on men's health.
Lead author Dr. Adrian Heald, of Salford Royal Hospital in the UK, said the finding came as a shock.
He said: "A woman with type 2 diabetes for example, might live five years less than the average woman in the general population, while someone diagnosed at a younger age might lose eight years of life expectancy."
Type 2 diabetes, the form linked to unhealthy lifestyles, is more common in men. It can lead to serious complications - such as amputations, heart disease and kidney failure.
Dr. Heald and his associates worked out the life expectancies of almost 12,000 local patients over a decade, comparing them to the general population matched for age and sex.
The analysis showed a woman with type 2 diabetes had a 60 percent increased chance of early death and will live five years less than a peer in the general population.
Dr. Heald said: "Our modelling suggests type 2 diabetes has a greater effect on the life expectancy of women, smokers and those diagnosed at a younger age."
The condition usually occurs in older people. But onset at a younger age is becoming more common globally, with rising obesity the main driver.
(Shift Drive via Shutterstock)
The study found smoking shortens the life expectancy of people with type 2 diabetes by ten years - and diagnosis before the age of 65 by over eight years.
Added Dr Heald: "It is vital the groups at the highest risk are made aware of not just the increased risk that they face but also the size of the risk.
"Doing so may make the health advice they are given seem more relevant and so help them make changes that can improve their quality - and length - of life."
Diabetes is known to increase the risk of premature death by up to 70 percent. But little is known about how demographic and lifestyle factors might have further impact.
The average age of participants was 66 and more than half (55%) were male. Data included health records from 2010 to 2020 - stopping before the COVId-19 pandemic.
Office for National Statistics figures on the life expectancy of the general population and information from the Index of Multiple Deprivation were also used.
During the study period, 3,921 of the individuals died, of whom 2,080 were men, compared to 2,135 expected.
This is based on a standardised mortality ratio (SMR) of 1.84 - meaning the risk of an early death was 84 percent higher overall, with women carrying the heaviest burden.
The findings stood after levels of deprivation were considered - Salford is one of the most disadvantaged areas of England.
Those diagnosed below 65 years old had a 93 percent higher risk of early death and lived more than eight years less than people of the same age in the general population. Those diagnosed at 65 and older lost less than two years.
Smoking had the largest effect on the mortality and life expectancy of people with diabetes.
The modelling found patients who smoked were two and a half times more likely to die prematurely.
They lived ten years less than those in the general population. Non-smokers and ex-smokers with diabetes lost three years of life expectancy.
The modelling found a female smoker who was diagnosed before the age of 65 was almost four times more likely to die prematurely.
She lived 15 years less than a woman in the general population of the same age.
Most diabetic symptoms are the same in men and women. They include constant thirst and urination, fatigue, dizziness and weight loss.
The results in the journal Diabetologia were presented at a meeting of the European Association for the Study of Diabetes in Stockholm.
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