Diabetes

28 June 2011

Diabetics' life expectancy improves

Advances in diabetes care have nearly eliminated the difference in life expectancy between people with type 1 diabetes and the general population, according to new research.

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Advances in diabetes care have nearly eliminated the difference in life expectancy between people with type 1 diabetes and the general population, according to new research.

Life expectancy at birth for someone diagnosed with type 1 diabetes between 1965 and 1980 was estimated to be 68.8 years compared to 72.4 years for the general population. But, for someone diagnosed with type 1 diabetes between 1950 and 1964 the estimated life expectancy at birth was just 53.4 years.

"The outlook for someone with type 1 diabetes can be wonderful," said the study's senior author, Dr Trevor Orchard, professor of epidemiology, medicine and paediatrics at the University of Pittsburgh Graduate School of Public Health.

Orchard said that more recent improvements in diabetes care will make the outlook even brighter for people diagnosed more recently.

"We'll see further improvements in life expectancy compared to the general population," he said.

Insulin and type 1 diabetes

Type 1 diabetes is an autoimmune disease, which means the body's immune system mistakenly sees healthy cells as foreign invaders, such as a virus. In type 1 diabetes, the immune system attacks cells in the pancreas that produce insulin, a hormone necessary for your body to use carbohydrates as fuel. Once these cells are destroyed, the body can no longer produce insulin. People with type 1 diabetes must replace the lost insulin through injections or an insulin pump or they would get very ill and could even die.

But, estimating the right amount of insulin you might need isn't an easy task. Too little insulin, and the blood sugar levels go too high. Over time, high blood sugar levels can damage many parts of the body, including the kidneys and the eyes. But if you get too much insulin, blood sugar levels can drop dangerously low, possibly low enough to cause coma or death.

Diabetes care today has advanced significantly since the people in Orchard's study were first diagnosed. Blood glucose meters weren't readily available back then. There were few choices in insulin, and there were no insulin pumps. It was far more difficult to maintain good blood sugar levels. And, Orchard noted that there was no way to measure long-term blood sugar control, as there is now. A test called the hemoglobin A1C can detect your average blood sugar levels for the past two to three months.

Orchard's study, known as the Pittsburgh Epidemiology of Diabetes Complications (EDC) study, included 390 people who were diagnosed with type 1 diabetes between 1950 and 1964, and 543 people who were diagnosed between 1965 and 1980.

The researchers found that the mortality rate was 11.6% for the 1965 to 1980 group and 35.6% for the 1950 to 1964 group.

Good news for diabetics

That means for people diagnosed with type 1 diabetes between 1965 and 1980, their life expectancy improved by 15 years. At the same time, the life expectancy for the general US population only improved by one year.

The gap between life expectancy for people with type 1 diabetes (diagnosed between 1965 and 1980) and the general US population is now just four years, according to the study.

Orchard said this new information should help people with type 1 diabetes who may be unfairly penalised with higher premiums when they try to purchase life insurance.

Dr Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City, called the new study "good research that's documenting what we're seeing. Our patients are doing much better. The morbidity is also much less. We used to see so much blindness and now we don't see that as much. I think this study is very reassuring."

Good blood sugar control is the key, said Zonszein.

Orchard agreed. "It's well worth getting good [blood sugar] control, as well as controlling blood pressure and [cholesterol]. These are all important." He added that people with type 1 diabetes who can avoid a kidney issue known as microalbuminuria actually have the same life expectancy as the average person in the United States.


(Copyright © 2010 HealthDay. All rights reserved.)

 

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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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