The results suggest that a woman with type 2 diabetes will live five years less than the average woman in the general population; Diagnosis at a younger age reduces life expectancy by more than eight years .
New research presented at the annual meeting of the European Association for the Study of Diabetes in Stockholm, Sweden (September 19-23) indicates that type 2 diabetes (T2D) most affects the mortality and life expectancy of women, younger people and smokers.
A woman with T2D is 60% more likely to die prematurely and will live five years less than the average woman in the general population. Meanwhile, men with T2D have a 44% higher risk of dying prematurely and living 4.5 years less, according to modeling by Mike Stedman of Res Consortium, a healthcare consultancy in Andover, UK, Dr Adrian Heald, of Salford Royal Hospital, Salford, United Kingdom, and colleagues, says.
Smoking shortens the life expectancy of people with T2D by ten years, while diagnosis at a younger age (before age 65) reduces life expectancy by more than eight years.
3.5 million people in the UK have been diagnosed with T2D, the most common form of the condition, and numbers are expected to rise in the coming years. It usually occurs in middle-aged and older people, but onset at a younger age is becoming more common around the world.
People with diabetes in England are known to have a 50-70% higher risk of dying prematurely than people without diabetes (this is known as the age-standardised mortality rate or SMR). However, little is known about how demographic and lifestyle factors may affect the size of this risk.
Researchers calculated the life expectancy of T2D patients in Salford, UK (11,806 participants, 55% men, average age 66.2 years) over a ten-year period and compared it to life expectancy figures life expectancy of the general population of the same age and sex. They then looked at the effect of demographic and lifestyle factors on the mortality rate and life expectancy of people with T2D.
Data used included participants’ health records from 2010 to 2020 (until before the COVID-19 pandemic), information from the Office for National Statistics on life expectancy of the general population, and information from the Index of Multiple Deprivation .
3,921 of the participants died (2,080 men) during the ten years studied, compared to the expected 2,135, giving a standardized mortality ratio (SMR) of 1.84, meaning that the risk of premature death was a 84% higher in people with diabetes than in the general population.
The increased risk of premature death was higher for women with T2D than for men with T2D (96% vs. 74% higher risk of premature death). This surprised researchers because T2D is generally assumed to have a greater effect on men’s health than women’s.
When the results were adjusted to take into account levels of deprivation (Salford is one of the most deprived areas in England), people with T2D still had a significantly increased risk of premature death.
Adjusting for deprivation, a woman with T2D was 60% more likely to die prematurely than someone in the general population, while a man with T2D was 44% more likely to die prematurely.
The results also suggest that T2D has a greater effect on the life expectancy of people diagnosed at a younger age. Those diagnosed under the age of 65 had a 93% higher risk of premature death and lived more than eight years less than people of the same age in the general population. Those diagnosed at age 65 or older lost less than 2 years.
Smoking had the greatest effect on mortality and life expectancy in people with T2D. The model found that people with T2D who smoked were 2.5 times more likely to die prematurely than people in the general population. Smokers with T2D lived ten years less than people in the general population; non-smokers and former smokers with T2D lost three years of life expectancy.
The model found that a female smoker who was diagnosed before age 65 was 3.75 times more likely to die prematurely and lived 15 years less than a woman in the general population of the same age.
Dr Heald says: “Our modeling suggests that type 2 diabetes has a greater effect on life expectancy in women, smokers and people diagnosed at a younger age.
“A woman with type 2 diabetes, for example, could live five years less than the average woman in the general population, while someone diagnosed at a younger age could lose eight years of life expectancy.
“It is vital that higher risk groups are aware not only of the increased risk they face, but also the size of the risk. Doing so can make the health advice they receive seem more relevant and help them make changes that can improve their quality and length of life.”
