The American Diabetes Association 71st Scientific Sessions:

Life Expectancy for People with Type 1 Diabetes Shows Dramatic Gains, Reaching Just 3.6 Years Less than Non-Diabetics

Life expectancy for people with type 1 diabetes increased by about 15 years for those diagnosed between 1965 and 1980, compared to those diagnosed between 1960 and 1964, according to a study presented at the 2011 American Diabetes Association meeting.

Life expectancy at birth was 68.8 years for the latter period, compared to 53.4 years in the earlier period (p<0.0001), according to the study of Pittsburgh-area residents (abstract 78-OR). The result for the younger cohort is that their life expectancy was just 3.6 years shorter than those without diabetes, the study found.

Many published studies have shown that mortality has been steadily declining among people with type 1, but the new study is among the first to examine gains in life expectancy, said the senior author of the paper.

“A large part of the improvement is related to renal disease,” said Trevor J. Orchard, MBBCh, professor of epidemiology, pediatrics and medicine at the University of Pittsburgh. “There was very little use of lipid-lowering drugs in the data I presented, so I think life expectancy will get even better in later cohorts.”

He and colleagues compared mortality and life expectancy among the 390 people diagnosed at the University of Pittsburgh and enrolled in the Pittsburgh Epidemiology of Diabetes Complications study between 1950 and 1964, and compared them to the 543 patients diagnosed and enrolled between 1965 and 1980.

The rate of 30-year mortality was found to have dropped from 35.6% in the earlier period to 11.6% in the later period (p<0.001). The resulting calculated gain in life expectancy was consistent by gender, age of onset, and pubertal stage.

The gains were checked against mortality and life expectancy rates in surrounding Allegheny County, and they were found to be similar.

“We feel these data are quite representative of the country overall,” Dr. Orchard said.

Following his presentation, the chairperson of the session posed a question.

“Are you able to do a bit of crystal ball gazing to tell us whether life expectancy in type 1 is going to reach the level of the background population, and when?” asked Polly Bingley, professor of diabetes in the school of clinical sciences at the University of Bristol, England.

“If you don’t develop microalbuminuria, life expectancy is already the same as in the general population,” said Dr. Orchard. “The closer we get to preventing microalbuminuria, the more we can close the gap.”

Dr. Orchard said he hoped the study would lead to a reduction in the excess costs currently charged to people with type 1 diabetes for life insurance policies. In the meantime, he said, endocrinologists should seek to convey to their patients the good news.

“We need to do a better job in communicating the positive outlook to patients,” he said.

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