Diabetic life expectancy 12 years less than average person
Two large studies have revealed that people with type 1 diabetes have a large gap in life expectancy compared to the general population.
The studies, published in Diabetologia (the journal of the European Association for the Study of Diabetes), show there has been little improvement in life expectancy for type one diabetics over the last few decades.
The first study examined 5,981 deaths of type 1 diabetic patients in Australia from 1997 to 2010.
Associate Professor Dianna Magliano and Dr Lili Huo from Baker IDI Heart and Diabetes Institute, Melbourne and colleagues found that deaths for those aged under 60 accounts for 60% of the years of life lost for men and 45% for women.
In the 10-39 year age group, they found that the major contribution to years of life lost was endocrine and metabolic diseases whereas in the over 40 age group, circulatory disease was the main contributor.
Overall, the researchers found that people with type 1 diabetes had an expectant life expectancy of 68.6 years, 12.2 years less than the average population (11.6 years less for men and 12.5 years less for women).
They also found the age when diabetes was diagnosed plays a critical role in determining the overall life expectancy.
“Our study shows a slight improvement in estimated life expectancy with increasing age at diagnosis,” they wrote.
They concluded: “Early onset of diabetes tended to be a predictor of premature mortality. Deaths from circulatory disease and endocrine and metabolic disease contributed most to early mortality in type 1 diabetes. For improvements in life expectancy, greater attention must therefore be paid to both the acute metabolic and chronic cardiovascular complications of type 1 diabetes. A failure to address either one will continue to leave type 1 diabetic patients at risk of premature mortality.”
In the second study, health records from the Swedish National Diabetes Register were linked with death records to examine life expectancy of Swedes with type 1 diabetes.
Dr Dennis Petrie from the University of Melbourne and Professor Björn Eliasson from the University of Gothenburg and colleagues found that although the life expectancy for men at age 20 with type 1 diabetes increased by about 2 years between 2002-06 and 2007 – 11, there was no change for women in the same time period.
They also noted that cardiovascular mortality significantly reduced for both men and women over the period which coincided with a large increase of the proportion of the population with type 1 diabetes who reported being on lipid-lowering medication.
“However, similar relative improvements in the general Swedish population for CVD were also observed, which suggests a similar uptake in lipid-lowering medication in the general population.”
The authors conclude: “There is still some way to go in terms of improvement in care for those with type 1 diabetes in order to close the gap with the general population.”
In a linked comment in Diabetologia, Dr Lars Stene from the Norwegian Institute of Public Health notes that the gap in life expectancy has remained largely unchanged since the turn of the millennium.
However he said that it’s perhaps not surprising that life expectancy hadn’t changed in the years outlined in the studies: “The differences in lifetime exposure to hyperglycaemia and other determinants of survival in the two overlapping groups of people with type 1 diabetes examined for mortality during these recent years may not be very different. We know that glycaemic control has long lasting effects.”
Dr Stene said general populations in Sweden, Australia and other countries have seen a recent reduction in cardiovascular mortality, an integral part of diabetes care.
“It is likely that patients with type 1 diabetes have enjoyed some of the beneficial developments that do not involve glycaemic control alone,” he wrote.