06 Apr Life Expectancy Still Shortened For Patients With Type 1 Diabetes
MedicalResearch.com Interview with:
Dr. Dennis James Petrie
Melbourne School of Population and Global Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Petrie: Life expectancy estimates for those with type 1 diabetes allow gaps with the general population to be identified and improvements to be quantified. This research examined mortality for those with type 1 diabetes in Sweden from 2002 till 2011. The aim was to explore whether life expectancy of those with type 1 diabetes has improved in Sweden over the last decade and how any improvement compared with improvements seen in the general population. It found that for men with type 1 diabetes, the remaining life expectancy at age 20 increased significantly by about 2 years (from 47.7 in 2002–06 to 49.7 years in 2007–11) but for women with type 1 diabetes there was no significant change, with a life expectancy at age 20 of 51.7 years in 2002–06 and 51.9 years in 2007–11. There have been recent gains for both men and women from reductions in cardiovascular mortality however these gains were also seen in the general population which meant that the life expectancy gaps have stayed at about 11 years for men and 12 years for women over the last decade in Sweden.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Petrie: Life expectancy estimates are averages based on the current mortality seen in whole population with type 1 diabetes so some individuals will live longer and shorter than this and this is likely to be influenced by their age at diagnosis, risk factor and comorbidities profiles. There is still some way to go in terms of improvement in care for those with type 1 diabetes in order to close the gap with the general population. A significant proportion have elevated HbA1c levels and a recent paper based on the Swedish NDR highlighted the stark differences in mortality for those with well-controlled vs poorly controlled HbA1c. In addition, with 10% of men and 13% of women with T1D still current smokers in 2011, additional smoking cessation programmes could generate further improvements. While there have been large increases in the use of lipid-lowering medication, further expansion could generate additional gains given this population’s high underlying cardiovascular disease risk.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Petrie: Future research needs to quantify these likely benefits which may improve the life expectancy of those with type 1 diabetes against the costs of policies which might achieve them. In addition, further research might also usefully provide individual specific life expectancy estimates based on an individual’s characteristics in terms of their age at diagnosis, and risk factor and comorbidity profiles. This would provide useful information for an individual and allow them to better grasp the likely benefits of improving their overall risk.
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Recent trends in life expectancy for people with type 1 diabetes in Sweden
Dennis Petrie1 & Tom W. C. Lung1,2 & Aidin Rawshani 3 & Andrew J. Palmer4 & Ann-Marie Svensson3 & Björn Eliasson3 & Philip Clarke1 Received: 8 September 2015 /Accepted: 19 February 2016 # Springer-Verlag Berlin Heidelberg 2016
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