Diabetics aged 50 lose eight years of healthy life

June 13, 2007

Sharnbrook, UK - Diabetics of age 50 will lose about eight years of healthy life compared with nondiabetics, primarily because of the earlier onset of cardiovascular disease, a new study shows[1].

The study, published in the June 11, 2007 issue of Archives of Internal Medicine, was conducted by a group led by Dr Oscar Franco (Unilever Corporate Research, Sharnbrook, UK). Franco told heart wire : "We showed that diabetes cuts out about eight good years of your life. While diabetics and nondiabetics have a similar number of years with cardiovascular disease, the disease process starts earlier in diabetics. That means diabetic patients reach the final stages of the movie prematurely by missing out on some of the best bits in the middle." He added: "These findings underscore the importance of diabetes prevention for the promotion of healthy aging. Toward this end, it is essential to implement global strategies to change the current Western lifestyle and to promote the adoption of physical activity and healthy diets."

 
Diabetic patients reach the final stages of the movie prematurely by missing out on some of the best bits in the middle.
 

In their paper, Franco and colleagues explain that while diabetes is a well-recognized risk factor for cardiovascular disease and mortality, there is only limited information on the association of diabetes with life expectancy with and without cardiovascular disease. Using data from the Framingham study, they set out to calculate the association of diabetes after age 50 with life expectancy and the number of years lived with and without cardiovascular disease. They built life tables using hazard ratios for three transitions (healthy to death, healthy to cardiovascular disease, and cardiovascular disease to death), stratifying by the presence of diabetes at baseline and adjusting for age and confounders.

Results showed that having diabetes significantly increased the risk of developing cardiovascular disease (hazard ratio 2.5 for women and 2.4 for men) and of dying when cardiovascular disease was present (hazard ratio 2.2 for women and 1.7 for men).

Women with diabetes had 8.2 years less life expectancy than women of the same age without diabetes, and diabetic women also lived on average more than eight years less free of cardiovascular disease. Men with diabetes had a reduction in total life expectancy of 7.5 years and a reduction in life expectancy free of cardiovascular disease of 7.8 years.

Effect of diabetes on life expectancy with and without cardiovascular disease at age 50 years (men)

Life expectancy (y) Without diabetes With diabetes
Total life expectancy 28.8 21.3
Life expectancy with CV disease 6.8 7.1
Life expectancy free from CV disease 22.0 14.2

Effect of diabetes on life expectancy with and without cardiovascular disease at age 50 years (women)

Life expectancy (y) Without diabetes With diabetes
Total life expectancy 34.7 26.5
Life expectancy with CV disease 6.6 6.8
Life expectancy free from CV disease 28.0 19.6

Franco commented to heartwire : "Healthy people aged 50 have a life expectancy of about 30 years, so reducing this by eight years, as diabetes does, cuts their life expectancy by almost 30%. Some people may say that they don't mind dying younger as long as they are healthy, but this is not what happens. Diabetics and nondiabetics both seem to develop heart disease at the end of their lives, and both groups live with heart disease for a similar length of time. But as this happens around eight years earlier for diabetes patients, they miss out on eight healthy years."

He added that while this type of analysis has been mathematically modeled previously, this is the first time this calculation has been done in a real population.

In the paper, the authors conclude that prevention of diabetes is a fundamental task facing today's society, with the aim to achieve populations living longer and healthier lives. "Taking into consideration that treatment of diabetes and its complications accounts for at least 10% of healthcare expenditure in many countries, effectively preventing diabetes will not only represent an increase in life expectancy and years lived without cardiovascular disease but also may represent important savings for healthcare," they add.

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