A recent study from 19 high-income countries has discovered that a diagnosis of type 2 diabetes may significantly reduce life expectancy, potentially shortening the life of someone diagnosed at age 50 by up to six years. The increasing number of diabetes cases globally is attributed to obesity, poor diet, and lack of physical activity. Researchers emphasize the urgent need for prevention strategies and highlight that an earlier diagnosis leads to a greater reduction in life expectancy.
According to an international team of researchers, an individual diagnosed with type 2 diabetes at the age of 30 could expect their life expectancy to decrease by as much as 14 years.
Even individuals diagnosed at the age of 50 could experience a reduction in life expectancy of up to six years, based on an analysis of data from 19 high-income countries.
“Given the impact type 2 diabetes will have on people’s lives, preventing – or at least delaying the onset – of the condition should be an urgent priority.” — Stephen Kaptoge
The findings of the study, published in The Lancet Diabetes & Endocrinology, underscore the need to develop and implement interventions to prevent or delay the onset of diabetes, especially as the prevalence of diabetes among younger adults is increasing globally.
Rising Prevalence and Health Risks
The rise in the number of type 2 diabetes cases worldwide is driven by increasing levels of obesity, poor diet, and sedentary behavior. In 2021, it was estimated that 537 million adults worldwide had diabetes, with a growing number of diagnoses occurring at younger ages.
Type 2 diabetes increases the risk of various complications, including heart attack, stroke, kidney problems, and cancer. Previous estimates have revealed that adults with type 2 diabetes may die, on average, six years earlier than those without diabetes. However, there is uncertainty regarding the variation in life expectancy reduction according to the age of diagnosis.
Research Study and Findings
To address this question, a team led by scientists at the University of Cambridge and the University of Glasgow examined data from two major international studies – the Emerging Risk Factors Collaboration and UK Biobank – consisting of a total of 1.5 million individuals.
The earlier the diagnosis of type 2 diabetes, the greater the reduction in life expectancy. Overall, for every decade of earlier diagnosis of diabetes, there was an average reduction of about four years in life expectancy.
Utilizing US population data, it was estimated that individuals diagnosed with type 2 diabetes at ages 30, 40, and 50 died, on average, about 14, 10, and 6 years earlier, respectively, compared to those without the condition. These estimates were slightly higher in women (16, 11, and 7 years, respectively) than in men (14, 9, and 5 years, respectively).
The findings were largely similar in analyses using EU data, with corresponding estimates of about 13, 9, or 5 years earlier death on average.
Expert Opinions
Professor Emanuele Di Angelantonio from the Victor Phillip Dahdaleh Heart and Lung Research Institute (VPD-HLRI), University of Cambridge, stated: “Type 2 diabetes used to be seen as a disease that affected older adults, but we’re increasingly seeing people diagnosed earlier in life. As we’ve shown, this means they are at risk of a much shorter life expectancy than they would otherwise have.”
Dr. Stephen Kaptoge, also from the VPD-HLRI, said: “Type 2 diabetes can be prevented if those at greatest risk can be identified and offered support – whether that’s to make changes to their behavior or to provide medication to lower their risk. But there are also structural changes that we as a society should be pursuing, including relating to food manufacturing, changes to the built environment to encourage more physical activity, and so on.
“Given the impact type 2 diabetes will have on people’s lives, preventing – or at least delaying the onset – of the condition should be an urgent priority.”
Impact of Diabetes on Mortality
The researchers found that a majority of the reduction in life expectancy associated with diabetes was due to ‘vascular deaths’ – deaths related to conditions such as heart attack, stroke, and aneurysms. Other complications, such as cancer, also contributed to lowering life expectancy.
Professor Naveed Sattar from the Institute of Cardiovascular & Medical Sciences, University of Glasgow, added: “Our findings support the idea that the younger an individual is when they develop type 2 diabetes, the more damage their body accumulates from its impaired metabolism. But the findings also suggest that early detection of diabetes by screening followed by intensive glucose management could help prevent long-term complications from the condition.”
Reference: “Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation” by Emerging Risk Factors Collaboration, 11 September 2023, The Lancet Diabetes & Endocrinology.
DOI: 10.1016/S2213-8587(23)00223-1
The Cambridge team was supported by the Medical Research Council, British Heart Foundation, Health Data Research UK and NIHR Cambridge Biomedical Research Centre.
