How a diagnosis of type 2 diabetes shortens life

How a diagnosis of type 2 diabetes shortens life

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Research conducted in 19 high-income countries reveals that a diagnosis of type 2 diabetes can significantly shorten life expectancy, with those diagnosed at age 50 potentially losing up to six years. The increasing cases worldwide are due to obesity, malnutrition and lack of activity. Researchers stress the urgent need for prevention strategies, noting that early diagnosis is associated with a greater reduction in life expectancy.

A person diagnosed with type 2 diabetes at the age of 30 could see their life expectancy reduced by up to 14 years, an international team of researchers has warned.

Even people who don’t develop the condition until later in life — with it being diagnosed at age 50 — can see their life expectancy reduced by up to six years, according to an analysis of data from 19 high-income countries.

“Given the impact type 2 diabetes has on people’s lives, preventing – or at least delaying the onset of – the condition must be an urgent priority.” — Stephen Captug

The researchers say that the results published in The scalpel Diabetes and endocrinologyHighlight the urgent need to develop and implement interventions that prevent or delay the onset of diabetes, especially as the prevalence of diabetes among younger adults is rising globally.

High prevalence and health risks

Increasing levels of obesity, malnutrition, and increasing sedentary behavior are leading to a rapid rise in the number of cases of type 2 diabetes worldwide. In 2021, it was estimated that 537 million adults had diabetes worldwide, with this number increasingly being diagnosed at younger ages.

Type 2 diabetes increases an individual’s risk for a range of complications including heart attack, stroke, kidney problems and cancer. Previous estimates suggest that adults with type 2 diabetes die, on average, six years earlier than adults without diabetes. However, there is uncertainty about how the average decline in life expectancy varies according to age at diagnosis.

Research study and results

To answer this question, a team led by scientists from the University of Cambridge and the University of Glasgow examined data from two major international studies – the Emerging Risk Factors Collaboration and the UK Biobank – involving a total of 1.5 million individuals.

The earlier an individual is diagnosed with type 2 diabetes, the greater the reduction in life expectancy. Overall, each decade of early diabetes diagnosis was associated with about four years of reduced life expectancy.

Using data from the US population, it is estimated that individuals with type 2 diabetes diagnosed at ages 30, 40, and 50 years died on average about 14, 10, and 6 years earlier, respectively, than individuals without the condition. . These estimates were slightly higher for women (16, 11, and 7 years, respectively) than for men (14, 9, and 5 years, respectively).

The results were broadly similar in analyzes using EU data, with the corresponding estimates indicating a death earlier than 13, 9 or 5 years on average.

Expert opinions

Professor Emanuele D’Angelantonio, from the Victor Philippe Dahdaleh Heart and Lung Research Institute (VPD-HLRI), University of Cambridge, said: ‘Type 2 diabetes used to be thought of as a disease of older people, but we are increasingly seeing people being diagnosed. earlier in life. As we have shown, this means that they are at risk of a much shorter life expectancy than they would otherwise have been.

Dr Stephen Captogi, also of VPD-HLRI, said: “Type 2 diabetes can be prevented if those most at risk can be identified and supported – whether that is making changes to their behavior or providing medication to reduce their risk. But there are also structural changes. We as a society should seek to pursue them, including changes related to food processing, changes to the built environment to encourage more physical activity, etc.

“Given the impact type 2 diabetes has on people’s lives, preventing – or at least delaying the onset of – the condition must be an urgent priority.”

Impact of diabetes on mortality

The researchers found that the majority of the reduction in life expectancy associated with diabetes was due to “vascular mortality” – deaths associated with conditions such as heart attack, stroke and aneurysms. Other complications such as cancer also contributed to lower life expectancy.

Professor Naveed Sattar from the Institute of Cardiovascular and Medical Sciences, University of GlasgowHe added: “Our findings support the idea that the younger an individual is when he develops type 2 diabetes, the more damage he accumulates in his body due to poor metabolism. But the results also indicate that early detection of diabetes through screening followed by Intensive glucose management can help prevent long-term complications of this condition.

Reference: “Age-related life expectancy at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation” by Emerging Risk Factors Collaboration, 11 September 2023, Lancet Diabetes and Endocrinology.
doi: 10.1016/S2213-8587(23)00223-1

The Cambridge team was supported by the Medical Research Council, the British Heart Foundation, Health Data Research UK and the Cambridge Biomedical Research Centre.

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