Women are 40% more likely to die from type 1 diabetes than men, according to new research, and twice as likely to die from heart disease.
Australian scientists found women with the condition were at greater risk of heart disease, stroke and kidney disease.
They say more research is needed - but suspect that women find it more difficult to control their insulin levels than men.
The research was published in The Lancet Diabetes and Endocrinology, with a meta-analysis of more than 200,000 patients conducted.
The researchers speculate that 'poorer glycaemic control and difficulties in insulin management' - issues that are more common in women - could be contributing to the higher risk of vascular-related death among women with type 1 diabetes.
Speaking about the results, lead author Prof Rachel Huxley said, "on average, women live longer than men. But, our findings show that in women with type 1 diabetes this 'female protection' seems to be lost and excess deaths in women with type 1 diabetes are higher than in men with the disease."
"The marked difference between the sexes for vascular-related disease is likely to have profound clinical implications for how women with type 1 diabetes are treated and managed throughout their lives," Prof Huxley added.