Estimated Life Expectancy in a Scottish Cohort With Type 1 Diabetes, 2008-2010 | Journal Scan

Study Questions:

Does life expectancy differ by the presence of type 1 diabetes compared to those without type 1 diabetes?


Data from the Scottish Care Information–Diabetes Collaboration database were used for the present analysis. This is a prospective cohort of patients residing in Scotland who have a physician diagnosis of diabetes. For this study, only those with type 1 diabetes and who were age 20 or older between 2008 and 2010 were included. The primary outcomes of interest were life expectancy and differences in life expectance between those with and without type 1 diabetes.


A total of 24,691 adults were included (contributing 67,713 person-years). During follow-up, 1,043 deaths occurred. Presence of type 1 diabetes was associated with reduced life expectancy compared to adults with no such diagnosis. Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% confidence interval [CI], 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 ml/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women), giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women), but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women).


The authors concluded that the estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy of approximately 11 years for men and 13 years for women compared with the general population without type 1 diabetes.


These data suggest a significant reduction in life expectancy among both men and women with type 1 diabetes with approximately one third of deaths due to ischemic heart disease. Aggressive prevention measures are warranted among this population.

Keywords: Diabetes Mellitus, Type 1, Diabetic Coma, Glomerular Filtration Rate, Ketosis, Life Expectancy, Menopause, Myocardial Ischemia, Scotland

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