Individuals with type 1 diabetes lose almost eight years of life compared to those without diabetes, while those with type 2 diabetes lose nearly two years, suggests a population-level analysis of mortality data.
The researchers note that the “sustained growth” in the number of patients with diabetes means that “effective early diagnosis and treatment…is vital” to avoid long-term comorbidities. In all, data on 41.3 million individuals registered at 6165 general practices were included in the analysis, of whom 217,000 were on the type 1 diabetes register and 2.5 million on the type 2 diabetes register. The team calculated that the average age of someone with type 1 diabetes in their cohort was 42.8 years, with an estimated future life expectancy of 32.6 years. This is compared with a future life expectancy of 40.2 years for an equivalent person without diabetes from the general population, which corresponds to an average lost life years (LLY) of 7.6 years per average person for someone with type 1 diabetes.
The average age of a person with type 2 diabetes in their study was 65.4 years, with a calculated future life expectancy of 18.6 years. In contrast, the average life expectancy for an equivalent person from the general population was 20.3 years, meaning that someone with type 2 diabetes had an LLY of 1.7 years per average person.
The researchers reasoned that lost life-years could be seen as a result of sub-optimal management, which can be viewed as poor glycemic control, as measured by HbA1c levels. Therefore, the total number of lost life days was allocated to the total number with higher HbA1c results and expected non-diabetes life expectancy to determine the number of life-days lost per life-year with elevated HbA1c. For your patients, the takeaway message is that for every year an individual with type 1 or type 2 diabetes spends with an HbA1c level greater than 7.5% (58 mmol/mol), their life could be shortened by approximately 100 life days.
Cardiovascular Endocrinology & Metabolism: June 2, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/XCE.0000000000000210