20 Jan Life Expectancy Increasing for Older, but Not Younger, Chinese with Diabetes
MedicalResearch.com Interview with:
Prof. Andrea On Yan LUK (陸安欣)
Associate Professor, Department of Medicine & Therapeutics
Faculty of Medicine, The Chinese University of Hong Kong
Specialist in Endocrinology, Diabetes and Metabolism
Honorary Associate Consultant, Hospital Authority
MedicalResearch.com: What is the background for this study?
Response: The overall mortality in people with diabetes has declined in many developed countries but little is known about the mortality trend in Asia. In this study, we examined the trend in mortality rates using a territory-wide database of 770,000 people with diabetes in Hong Kong.
MedicalResearch.com: What are the main findings?
Response: The main findings are three-fold.
- Firstly, the all-cause mortality rates in Hong Kong men and women aged >20 years have declined by 50% over a 16-year period from 2001 to 2016. The standardised mortality ratios which relate mortality in people with diabetes to people without diabetes have also decreased from 2.8 to 1.5 in men and from 3.3 to 1.7 in women during this period.
- Secondly, decreases in all-cause mortality were restricted to people aged 45 years or above and not in younger age groups between 20-44 years in whom the mortality rates remained up to 5-fold higher than age-matched people without diabetes.
- Thirdly, compared with people without diabetes, the life expectancy in people with diabetes presenting at an age of 40 years was shortened by up to 8 years. The anticipated life loss was less in people presenting with diabetes at older ages.
MedicalResearch.com: What should readers take away from your report?
Response: The overall declines in mortality rates in Hong Kong people with diabetes are consistent with observations in other developed countries in the west. Besides advances in medical sciences, changes in the social and healthcare systems in Hong Kong as well as government policies to reduce health and behavioural risk factors are important elements contributing to the reduction in mortality. However, any efforts to improve the health of people with diabetes were not reaching the younger people whose outcomes in terms of mortality rates have not decreased over a 16-year period. Therefore, the care of young people who will be exposed to a life time of diabetes and accompanying morbidities, remains an unmet need in Hong Kong.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Diabetes mellitus is associated with increased risks of a range of complications including cardiovascular diseases, kidney diseases and cancer. We would like to explore the trends in the incidence rates of these complications in order to understand the impact of provision of diabetes care over time.
Wu, H., Lau, E.S.H., Ma, R.C.W. et al. Secular trends in all-cause and cause-specific mortality rates in people with diabetes in Hong Kong, 2001–2016: a retrospective cohort study. Diabetologia (2020) doi:10.1007/s00125-019-05074-7
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