Life Expectancy of Type 1 Diabetics

What is Type 1 Diabetes?

Type 1 diabetes, earlier also known as insulin-dependent diabetes or juvenile diabetes, is a chronic health condition in which the pancreas stops producing insulin or produces little insulin.1 Insulin is the hormone that your body needs to allow glucose (sugar) to enter the cells for producing energy.

There are many different factors that contribute to type 1 diabetes, including genetics and certain viruses even. Usually, type 1 diabetes starts to develop in childhood itself, but it can also develop in adults.

The signs and symptoms of type 1 diabetes tend to appear suddenly and may include:

In spite of the vast amount of research being done on type 1 diabetes, there is still no cure for the condition, and treatment revolves around the management of blood sugar levels with insulin, healthy diet and lifestyle for preventing complications.

Life Expectancy of Type 1 Diabetics

Life Expectancy of Type 1 Diabetics

The life expectancy of a person with type 1 diabetes has been found to be 10 to 15 years lesser than someone who does not have type 1 diabetes.

In fact, an observational study2 done in Sweden and published in The Lancet has found that life expectancy for people who have developed type 1 diabetes at a young age is on an average, 16 years lesser than people who do not have diabetes, and 10 years lesser than those who are diagnosed with the condition at an older age.

The research found that being diagnosed with type 1 diabetes at a younger age is also related to a higher risk of premature death as well as cardiovascular complications at a later stage in life.

The study, carried out by the University of Gothenburg, followed over 27,000 participants who had type 1 diabetes and over 135,000 matching controls for a period of ten years. Half of these participants were diagnosed with type 1 diabetes before the age of 14 years. The authors of the study found that there was a higher risk of cardiovascular diseases in people who have an early diagnosis of type 1 diabetes. However, the research also found that the age of disease onset was also an essential factor in determining life expectancy as well.

Another study3 carried out by the University of Dundee School of Medicine in Scotland found that people with type 1 diabetes are likely to lose over 10 years of life due to the disease, in spite of advanced treatments for not just diabetes, but also its complications.

The study, published in the Journal of the American Medical Association, found that men with type 1 diabetes end up losing 11 years of their life expectancy as compared to men who do not have diabetes. At the same time, women who have type 1 diabetes, lose 13 years of their life expectancy due to the disease. The findings of this study provided a more realistic picture of just how type 1 diabetes cuts into a person’s life span, in spite of all the advanced treatments available for managing the condition.

According to the study, the impact of type 1 diabetes on heart health was the single biggest cause of mortality. It was also found that apart from cardiovascular issues, people affected by type 1 diabetes and younger than 50 years were also dying because of the conditions caused by the management of type 1 diabetes. This included diabetic coma caused by ketoacidosis and low blood sugar. Ketoacidosis is caused by a lack of insulin in the body.

Another study4, also published in the Journal of the American Medical Association and carried out by the University of Tennessee Health Science Center in Memphis, United States, discovered that many of the early diabetes-related deaths could actually be prevented with intensive management of patients’ blood sugar levels.

In this study, the researching team lowered the participants’ overall risk of premature death by nearly a third as compared to diabetic patients receiving standard care. They achieved this by carrying out multiple blood sugar tests throughout the day and also by continually adjusting the patients’ insulin levels to target precise blood sugar levels. The results found that the patients who had better blood sugar control due to the intensive therapy and monitoring the team performed had an increased survival rate. The researchers successfully observed a 44 percent decrease in the overall risk of premature death for every 10 percent decrease in the levels of hemoglobin A1C.

Hemoglobin A1C is a blood test that is used to determine a person’s average levels of blood sugar over a period of three months. This intensive therapy and monitoring lasted for 6.5 years. After the study came to an end, the patients were also taught about how to carry out the same intensive management of their blood sugar levels and were even urged to continue to use the techniques in order to prolong their life. The tracking of these patients’ health and progress continued until the end of 2012. After an average of 27 years of follow-up and monitoring, the research team found that the likelihood of dying was one-third lesser for the group of patients who continued the intensive management of blood sugar levels.

Summary

Diabetes care has been witnessing many new developments in terms of technology and management of the disease. It is now quite easy for patients to do continuous glucose monitoring from the comfort of their home itself. The technology behind insulin delivery is also at a far advanced stage, making it easier for a large number of patients to achieve the same intensive level of glucose control that was achieved by the patients discussed in the study above.

Things also look more positive than ever before when it comes to the life expectancy in type 1 diabetes. In the 1920s, people diagnosed with type 1 diabetes had a life expectancy of a couple of months to a year. Today, with the discovery of insulin and many other technologies allowing for better disease management, the life expectancy of type 1 diabetics are better than before, and it is expected to only get better in the future with more advances and stronger blood glucose control.

References:

  1. Eisenbarth, G.S., 2005. Type 1 diabetes mellitus. Joslin’s diabetes mellitus, 14, pp.399-424.
  2. Rawshani, A., Sattar, N., Franzén, S., Rawshani, A., Hattersley, A.T., Svensson, A.M., Eliasson, B. and Gudbjörnsdottir, S., 2018. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. The Lancet, 392(10146), pp.477-486.
  3. Wise, J., 2016. Type 1 diabetes is still linked to lower life expectancy.
  4. Handelsman, Y., Mechanick, J., Blonde, L., Grunberger, G., Bloomgarden, Z., Bray, G., Dagogo-Jack, S., Davidson, J., Einhorn, D., Ganda, O. and Garber, A., 2011. American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for developing a diabetes mellitus comprehensive care plan: executive summary. Endocrine practice, 17(2), pp.287-302.

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