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Life expectancy drops with type 2 diabetes plus cardiometabolic morbidities
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Korean adults with type 2 diabetes and other cardiometabolic comorbidities, including stroke and myocardial infarction, have decreased life expectancy and increased number of life-years lost vs. those without diabetes and other comorbidities, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Chang Hee Jung, MD, PhD, of the department of internal medicine, Asan Medical Center, University of Ulsan College of Medicine in Korea, and colleagues evaluated data from the Korean National Health Insurance Service-National Sample Cohort on 569,831 adults enrolled between 2002 and 2006 and followed for a median of 12 years to determine mortality and reductions in life expectancy associated with cardiometabolic multimorbidity.
Participants were divided into five groups based on baseline disease status: none (reference group; n = 92.59%), diabetes (7.01%), diabetes and stroke (0.14%), diabetes and MI (0.06%) or diabetes, stroke and MI (0.01%).
All-cause mortality rate was highest among participants with diabetes, stroke and MI (115.52 per 1,000 person-years), followed by participants with diabetes and stroke (67.17 per 1,000), diabetes and MI (66.34 per 1,000) and diabetes only (19.86 per 1,000); the reference group had the lowest all-cause mortality rate (6.85 per 1,000). Similarly, the HRs for mortality were higher in participants with a history of diabetes (HR = 1.7; 95% CI, 1.66-1.75), diabetes and stroke (HR = 3.66; 95% CI, 3.32-4.03), diabetes and MI (HR = 3.56; 95% CI, 3.06-4.14) and diabetes, stroke and MI (HR = 4.79; 95% CI, 3.05-7.05) compared with the reference group.
Life expectancy decreased with increasing age. Compared with participants without diabetes, participants with diabetes lost an overall 6.1 life-years to diabetes. Compared with the reference group, life-years lost were higher in participants with diabetes and stroke (16.68), diabetes and MI (21.1) and diabetes, stroke and MI (23.8).
Younger age groups with comorbidities had a reduced life expectancy compared with younger age groups without the comorbidities.
“For the first time in Asia, we observed the additive mortality risk and significantly shorter age-specific life expectancy, depending on the number of cardiometabolic morbidities. ... Although the extent of the mortality risk and loss of life expectancy was less than that in Western studies, our results suggest that young Asians with diabetes should be followed and managed more stringently, according to their [CV] comorbidities,” the researchers wrote. – by Amber Cox
Disclosures: The researchers report no relevant financial disclosures.
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