Study Estimates Average Life Years Lost from Type 1, Type 2 Diabetes

Adrian Heald, MD

New research from the University of Manchester offers an updated overview of the reduction in life expectancy associated with type 1 and type 2 diabetes compared against the general population.

Presented at the European Association for the Study of Diabetes (EASD) 2020 annual meeting, results of the study suggest the average person with type 1 diabetes will live nearly 8 years less and those with type 2 diabetes will live almost 2 years less than their counterparts in the general population.

"Knowledge of this may act as an incentive for clinicians to ensure that all people are on the best therapy to keep their blood sugar in the target range, and for those people to engage more strongly with their therapy and lifestyle recommendations,” noted study authors.

With many previous analyses of lost life years relying on older data, a team led by Adrian Heald, MD, sought to quantify the average reduction in life expectancy associated with type 1 and type diabetes, respectively, among patients using more recent data. With this in mind, investigators identified the UK National Diabetes Audit (NDA) and the Office for National Statistics (ONS) as data sources for their analysis.

Using the ONS, investigators performed a search of data from 2015-2017 and extracted actual mortality rates and projected life expectancy of the general population for each age year and sex. Through a search of the UK NDA from 2015-2016, investigators obtained information related to mortality rates for people with type 1 diabetes and type 2 diabetes in 5 different age groups and each sex as a ratio to the general population.

In total, investigators obtained data from more than 6000 general practices providing care to 41.3 million patients. Of these 41.3 million, 217k had type 1 diabetes and 2.5 million had type 2 diabetes.

Upon analysis, investigators found the average person with type 1 diabetes was 42.8 years of age and had a life expectancy from now of 32.6 years. In comparison, people the same age without diabetes were expected to live 40.2 years from now. For type 2 diabetes, the average patient was 65.4 years old and had a life expectancy from now of 18.6 years. In comparison, patients the same age without diabetes were expected to live 20.3 years from now.

Results of the investigators’ analysis also suggested each year with an HbA1c greater than 58 mmol/mol equated to a loss of around 100 life days for both type 1 and type 2 diabetes. Additionally, investigators noted their hope that further research into associations of glycemic control with mortality could improve care and management efforts.

“Linking poor glycemic control to expected mortality in such a quantitative way may incentivize clinicians and people with diabetes and poor blood sugar control to increase their efforts to achieve targets,” investigators added. Communication of life years lost from now to patients at the time of consultation with healthcare professionals and through messages publicized by advocacy groups such as Diabetes UK and other national/international patient facing organizations will be of great help in terms of dissemination of the conclusions of this study.”

This study, “Estimating life years lost to diabetes: outcomes from analysis of National Diabetes Audit and Office of National Statistics data,” was presented at EASD 2020 and published in Cardiovascular Endocrinology and Metabolism.