Improvement of Care & Outcome


Silvia de Vries, Carianne Verheugt, Dick Mul, Max Nieuwdorp, Theo Sas

Do sex differences in paediatric type 1 diabetes care exist? A systematic review. Diabetologia. 2023 Apr;66(4):618-630. Epub 2023 Jan 26.

Sex differences exist in outcomes among adults with T1D, which typically start in childhood. E.g., females with T1D have an higher risk of all-cause mortality than males with T1D. Not much is known yet about the influence of sex on T1D care and outcomes in childhood. This review, co-authored by Dick Mul and Theo Sas of Diabeter, aimed to provide a literature overview of paediatric sex differences, looking at person and disease characteristics, treatment, comorbidities and complications.


MEDLINE was searched with the terms diabetes mellitus, sex characteristics, sex distribution, children and/or adolescents, resulting in 8,640 eligible articles of which 90 were included for review (n=643,217 individuals).

Key findings:

  • Higher HbA1c in young female children, at diagnosis and during treatment
  • HbA1c increases faster in young female children
  • Higher BMI, prevalence of being overweight/obese and of dyslipidaemia among female children
  • More frequent hypoglycemia and partial remission among male children 
  • Female children are on pump therapy more frequently and need higher insulin doses 
  • Female children show lower quality of life 



Concluding, the authors state

" disparities are observed in a variety of daily clinical variables and outcomes in the paediatric type 1 diabetes population, specifically among female adolescents. Most striking differences are seen regarding glycaemic control, BMI, ID, DKA and QoL. These differences suggest a less favourable clinical profile for young female individuals, with potential consequences later in life" -

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