Do sex differences in paediatric type 1 diabetes care exist? A systematic review
Authors' conclusion
Sex disparities were observed throughout diabetes care in children with type 1 diabetes. Several outcomes appear worse in young female children, especially during adolescence. Focus on the cause and treatment of these differences may provide opportunities for better outcomes.
Study context
- Population
- Children and/or adolescents with T1D; primary outcome studies mentioning a sex difference in outcome (MEDLINE to 15 June 2021)
- Participants
- 643,217 adolescents90 studies
- Comparison
- Female vs male children with T1D
- Outcome
- Sex differences in characteristics, treatment, comorbidities and complications
Methodological detailsnarrative synthesis, adapted Harvest plot, Joanna Briggs Institute critical appraisal
- Narrative synthesis
- Adapted Harvest plot
- Joanna Briggs Institute critical appraisal
Pooled result
As reported in the abstract
- Higher HbA1c in females at diagnosis (7 studies, n=22,089)
- Higher HbA1c in females during treatment (20 of 21 studies, n=144,613), with steeper HbA1c increase over time
- Higher BMI in females (all ages: 10 studies, n=89,700; adolescence: 7 studies, n=33,153), more overweight/obesity and dyslipidaemia
- Hypoglycaemia and partial remission more often in males
- Ketoacidosis at diagnosis (8 studies, n=3561) and hospitalisation more often in females
- Females used pump therapy more often (6 studies, n=211,324) and needed higher insulin doses
- Thyroid and coeliac disease appeared more common in females
- All studies reported lower quality of life in females (15 studies, n=8722)
- Observational studies; causality cannot be concluded
- Studies with neutral outcomes may have been under-targeted
Original publication
Do sex differences in paediatric type 1 diabetes care exist? A systematic review. Diabetologia. Published 26 January 2023. doi:10.
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