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Reduced life expectancy, disability-free years for adults with diabetes
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Adults with diabetes face reduced life expectancy and more years living with a disability than adults without diabetes, according to an analysis of national diabetes, disability and mortality data in Australia.
In addition, women aged at least 50 years with diabetes spent more absolute years and a larger proportion of their life with a disability than men with diabetes and women and men without diabetes.
“Most are familiar with the classical complications [of diabetes] affecting eyes, kidneys, feet and the cardiovascular system, but this study highlights another impact,” Dianna Magliano, BAppSci, MPH, PhD, associate professor and senior epidemiologist at Baker IDI Heart and Diabetes Institute, in Melbourne, Australia, told Endocrine Today. “The physical disability that this study points to is of uncertain pathophysiology, but is likely to have a major impact on the lives of people with diabetes. Recognizing this is the first step in taking action to address it.”
Dianna Magliano
Magliano and colleagues analyzed 2011 mortality data from the National Diabetes Services Scheme, linked to the National Death Index in Australia, to determine all-cause mortality rates for people with diabetes, as well as national mortality rates for the general population from the Australian Institute of Health and Welfare. Researchers measured the prevalence of disability using the 2012 Australian Survey of Disability, Ageing and Carers (SDAC) and diabetes prevalence using the Australian Diabetes, Obesity and Lifestyle study.
At age 50 years, men with diabetes had an estimated life expectancy of 30.2 years (95% CI, 30-30.4), an estimated disability-free life expectancy of 12.7 years (95% CI, 11.5-13.7) and another 17.5 years of life expectancy with a disability, with 5.8 years spent with severe or profound core activity limitation. Women with diabetes aged 50 years had an estimated life expectancy of 33.9 years (95% CI, 33.6-34.1), an estimated disability-free life expectancy of 13.1 years (95% CI, 12.3-13.9) and another 20.8 years of life expectancy living with a disability, including 9.2 years spent with severe or profound core activity limitation. When compared with adults without diabetes, the estimated loss of life expectancy associated with diabetes at age 50 years was 3.2 years for men (95% CI, 3-3.4) and 3.1 years for women (95% CI, 2.9-3.4). Corresponding estimated loss of disability-free life expectancy was 8.2 years for men (95% CI, 6.7-9.7) and 9.1 years for women (95% CI, 7.9-10.4).
After hypothetically eliminating diagnosed diabetes, adults aged 50 years gained 0.6 years in life expectancy (95% CI, 0.5-0.6) and 1.8 years in disability-free life expectancy (95% CI, 1.0-2.8), including 1.1 years without severe core activity limitation.
“This suggests that the impact of diabetes on the quality of life is larger than the impact on length, which could partly be explained by an aging population and declining mortality in diabetes,” the researchers wrote. – by Regina Schaffer
For more information:
Dianna Magliano, BApp Sci, MPH, PhD, can be reached at Baker IDI Heart and Diabetes Institute, level 4, 99 Commercial Road, Melbourne, VIC, 3000, Australia; email: dianna.magliano@bakeridi.edu.au
Disclosure: The researchers report no relevant financial disclosures.
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