Does diabetes shorten our lives?

[Insulin_John]

I know that a badly-managed type 1 diabetes will cause "complications" (itself a multitude of sins) later in life, but how about a moderately-managed type 1?

I'm talking about myself, I'm 45 and test & inject regularly, but do not lead a strict regime of no beer/fatty foods etc and only exercise intermittently (I used to be very physically fit). I am always failing to drum up the will to be strict about my lifestyle.

As blokes don't live as long as women anyway (usually), would you say that diabetes shortens our lives at all?

 

[mrburden]

I would say that whilst it probably doesn't "shorten" our lives, diabetes increases our risk of other problems such as high blood pressure, stroke or heart attack etc. all of which can reduce the life expectancy. I suppose this is a statistical question with the answer being based on statistics too. Some will be lucky to see a ripe old age while others will not, but bring statistics into play and we, as diabetics, are probably seen as more likely to die at a younger age generally

 

[xyzzy]

but bring statistics into play and we, as diabetics, are probably seen as more likely to die at a younger age generally

I feel if you manage your diabetes reasonably well with a decent but not necessarily brilliant HBA1c and therefore minimise the risk of developing specific diabetic problems, eyes, feet etc. then the risk factors become the same as a non diabetic. At that point if you are overweight you run the risks of heart attacks and strokes or whatever in the same way as non diabetics. If you bring your risks back in line with those of an averagely healthy non diabetic you should statistically live as long as people in that grouping. That's my plan at least. I'm determined something else will get me first!

 

[Pneu]

Badly managed type I diabetes can cause complications within 10 years... or less if you are particularly unlucky... I think if your generally well controlled (and by that I mean sub 6.5% HbA1c) then I don't see that it's going to make a massive difference.. certainly I think as with anything in life some people are just 'hardier' than others.. and is all a bit luck of the draw...

 

[borofergie]

would you say that diabetes shortens our lives at all?

Yes it does.

These are for T2 diabetes (which is rightly considered to be less serious in general than T1 diabetes), but they show how life expectancy changes with HbA1c, blood-pressure, HDL-cholestral ratio and by whether you smoke or not:
http://eurheartj.oxfordjournals.org/content/30/7/834.full.pdf

All other things being equal, the difference be a HbA1c of 6% and 10% is 1.5 to 2 years of life (which is probably not as much as I'd expect). Unfortunately the tables don't go down as far as 5%.

Looking at these tables pretty much convinced me to pay more serious attention to my blood-pressure.

@55 the difference in life expectancy between someone with a low HbA1c (6%), low cholesterol and low blood-pressure, and someone with high HbA1c (10%), high cholesterol, and high blood pressure is about 5 years.

 

[viviennem]

I agree with Grazer and Pneu - I intend to control my diabetes so that I keep my chances of living my full course just the same as a non-diabetics. I certainly don't want 'complilcations'.

Besides - if you'll tell me how long I'm going to live, I'll come back and tell you whether it was longer or shorter after I'm dead! :lol:

I can take all the care of myself in the world, but there may be a bus out there with my number on it. Or a stone might fall off a building and hit me on the head. It's not worth worrying about; just do your best to look after yourself properly, and enjoy every day as it comes.

Though I hope it's not just yet, 'cos I've got some reports to finish . . . :wink:

Viv 8)

And I'm not going to read Borofergie's link (though thanks, Stephen) 'cos I don't want to depress myself.

 

[borofergie]

I agree with Grazer and Pneu - I intend to control my diabetes so that I keep my chances of living my full course just the same as a non-diabetics. I certainly don't want .

Nah. I'm with you and the boys Viv. I think that if you keep you HbA1c as low as possible then you'll minimise the chance of future complications. At 5.2% my BG is very different from a non-diabetic, so it's hard to see how I'm causing that much damage. As I wrote elsewhere, I'm 50lbs lighter and fitter than I've ever been because of diabetes. I think that being diagnosed probably increased my life expectancy. Even if that isn't true, it suits me to believe it.

 

[Unbeliever]

I agree with Grazer and Pneu - I intend to control my diabetes so that I keep my chances of living my full course just the same as a non-diabetics. I certainly don't want .

Nah. I'm with you and the boys Viv. I think that if you keep you HbA1c as low as possible then you'll minimise the chance of future complications. At 5.2% my BG is very different from a non-diabetic, so it's hard to see how I'm causing that much damage. As I wrote elsewhere, I'm 50lbs lighter and fitter than I've ever been because of diabetes. I think that being diagnosed probably increased my life expectancy. Even if that isn't true, it suits me to believe it.

Complications don't necessarily shorten your life , of course,thy just just make it more miserable! Given a choice I think I would opt for a shorter complication-free life.

Certain underlying weaknesses or latent genetic disorders probably also make complications more likely but all anyone can
do is to try to maintain good control. When medication is also involved there is the benefit /risk hing o be considered too.r.
Those of you who manage to stay in control but without medication must have a much higher chance of living longer han the rest of us.

 

[mrburden]

One way to decide if diabetics are likely to die younger than non-diabetics is to apply for life insurance twice, once as a diabetic and once as a non-diabetic. The cost of each quote should reflect the approximate life expectancy (or the unfairness of the insurance industry, depending on your individual view of such!).

 

[xyzzy]

Interesting tables Stephen and I know you believe them as little as I do or I hope so.

If you read the fine print. The table of life expectancy is built from a computerised model of what happens to T2D people with those cholesterol, HBA1C and BP statistics. It makes one BIG assumption in that any of the measured values if diagnosed at say 55 is assumed to remain the same over time.

It also assumes for any one of those Type 2's that their BMI is in the obese range 30 to 33 throughout their diagnosed lifespan as far as I read it. They state they keep the BMI static because it has the least effect on outcome as it only effects the risk of congestive heart failure by only a 7% increase per point of BMI so the tables do not take into account someone who loses a load of weight and for instance takes themselves out of the obese greater than 30 BMI range back into the normal sub 25 range.

Like many of these things there is an underlying "social bias" assumption that T2D is progressive in the sense that people who get it will always follow a particular average path regarding weight and medication etc. So for example those life expectancy values are all based on people who are always obese and never do anything to either become not obese and WILL keep the same levels of cholesterol, BP and HBA1C throughout their lifespan. A very extreme case of biasing your results because of beliefs. It's either that or their model is inadequate to cope with T2D's who want to change their lifestyle and therefore is not a reliable model.

Even if I were to agree that for whatever reason the model accurately reflects Mr average T2 "out there" I refuse to be an average statistic! I simply refuse to believe that if I normalise all aspects of common risks such as cholesterol, blood pressures, HBA1c and BMI (weight) to that of a healthy non diabetic that because I have to eat a slightly different and in most cases HEALTHIER diet than Mr average non diabetic I'm still going to die younger.

So still NOT going to get me...

 

[Sid Bonkers]

One way to decide if diabetics are likely to die younger than non-diabetics is to apply for life insurance twice, once as a diabetic and once as a non-diabetic. The cost of each quote should reflect the approximate life expectancy (or the unfairness of the insurance industry, depending on your individual view of such!).

The 'problem' with insurance underwriters MrB is that they dont allow for the individual but rather make their underwriting decisions based on statistics and statistically diabetics have a shorter life expectancy. The truth is that the statistics they use will include those diabetics who never get anywhere near the recommended bg levels let alone get below them.

Controlling bg levels to as low a level as is acceptable to your lifestyle can only help to give you a better life expectancy and a better general level of health. Unfortunately many diabetics are not diagnosed until after complications have taken place but even those people will only benefit from good control.

The biggest threat to diabetics is cardiovascular disease, so the most you can do to prevent damage to your heart and vascular system would seem to be the best option and that for me means good control of bg levels and avoiding excess saturated fat and salt to my diet.

 

[Grazer]

And I'm not going to read Borofergie's link (though thanks, Stephen) 'cos I don't want to depress myself.

Actually, I read it and it did the reverse for me. Cheered me up! My nearest table is age 65. It shows my life expectancy (non-smoker, HbA1c 6 although I'm lower, cholesterol 4, BP 120) to be not much different to normal at about 80. Given that that is for someone who is overweight, and I'm not, things look rosy in my mind!
I compare it to where I was BEFORE diagnosis. BP 145+(now 120), cholesterol 5.5 (now 3.8), BMI 25.8 (now 22). I think diabetes has EXTENDED my life expectancy.
Happy days! :thumbup: :clap:

 

[borofergie]

Interesting tables Stephen and I know you believe them as little as I do or I hope so.

Even if I were to agree that for whatever reason the model accurately reflects Mr average T2 "out there" I refuse to be an average statistic! I simply refuse to believe that if I normalise all aspects of common risks such as cholesterol, blood pressures, HBA1c and BMI (weight) to that of a healthy non diabetic that because I have to eat a slightly different and in most cases HEALTHIER diet than Mr average non diabetic I'm still going to die younger.

So still NOT going to get me...

Whatevs xyzzy. You're just upset that you found yourself on one of the tables and realised that your time is nearly up

You're right of course, I don't believe them any more than you. I personally think that we are a new generation of informed diabetics, who understand how to control our disease and (if we choose to) will not suffer the same consequences as previous generations who weren't privy to the right information (and support) to help themselves.

I do think that the tables are a good illustration of the potential impact of T2 diabetes, and I think that the modelling assumptions are entirely reasonable (acutaries are a pretty unemotional lot). But I'm with Malc, the tables are a lot less forgiving of a high HbA1c than I would have imagined.

 

[xyzzy]

The truth is that the statistics they use will include those diabetics who never get anywhere near the recommended bg levels let alone get below them.

Agree Sid but my belief is that the reason a large number of those diabetics who never get near "normal" healthy figures is in a large part due to the bias and expectations currently built into health care system and not the people themselves. If that system told patients "the truth" (yes you and I may differ on some aspects of what the truth is) then many more diabetics like you and me would change and therefore those statistics would change too. Neither you or I are anywhere near "the average" :lol:

If you change the statistics then implicitly you change those averages that not only effect mundane things life insurance companies and their quotes but also real tangible things like life expectancy.

 

[mrburden]

One way to decide if diabetics are likely to die younger than non-diabetics is to apply for life insurance twice, once as a diabetic and once as a non-diabetic. The cost of each quote should reflect the approximate life expectancy (or the unfairness of the insurance industry, depending on your individual view of such!).

The 'problem' with insurance underwriters MrB is that they dont allow for the individual but rather make their underwriting decisions based on statistics and statistically diabetics have a shorter life expectancy. The truth is that the statistics they use will include those diabetics who never get anywhere near the recommended bg levels let alone get below them.

Controlling bg levels to as low a level as is acceptable to your lifestyle can only help to give you a better life expectancy and a better general level of health. Unfortunately many diabetics are not diagnosed until after complications have taken place but even those people will only benefit from good control.

The biggest threat to diabetics is cardiovascular disease, so the most you can do to prevent damage to your heart and vascular system would seem to be the best option and that for me means good control of bg levels and avoiding excess saturated fat and salt to my diet.

Sid,
I quite agree with your comments regarding what is essentially self-help. If we don't use statistics, which unfortunately fail to distinguish between those of us who do look after ourselves and those who don't, we are left with the question of how long will an individual live - something that many would like to know but will not find out until it's too late to be of use. So really the OP's question is unanswerable. The nearest thing to a sensible answer is that we can strive to be as fit as a non-diabetic but we are still as likely to die from a random event as the statistics suggest.

 

[borofergie]

I quite agree with your comments regarding what is essentially self-help. If we don't use statistics, which unfortunately fail to distinguish between those of us who do look after ourselves and those who don't, we are left with the question of how long will an individual live - something that many would like to know but will not find out until it's too late to be of use. So really the OP's question is unanswerable. The nearest thing to a sensible answer is that we can strive to be as fit as a non-diabetic but we are still as likely to die from a random event as the statistics suggest.

But the actuarial statistics do distinguish between levels of control. In the tables that I found they distinguished between HbA1c, BP, cholesterol and whether you smoke or not. Those are all pretty sensible metrics to base your estimation of life expectancy. What's better is that the actuarial predictions also include the change that you will die of a "seemingly" random event (like getting hit by a bus, or dying in a plane crash).

 

[xyzzy]

Whatevs xyzzy. You're just upset that you found yourself on one of the tables and realised that your time is nearly up

Nope and that's my point I'm not on those tables at all. For example there is no column for people with a 5% HBA1c (which I must admit 3 months after diagnosis I probably don't yet have but you get my point) and it doesn't show life expectancies for someone with my BMI of 25.5 let alone in the normal range.

Look at it this way the set of numbers 50, 50, 50 have the same average as the set of numbers 0, 50, 100. Lets say those numbers are actually the percentage chance of dying from CVD by the time you are 80. The average of both sets 50. Now if you were a person who scored either 0 or 100 in the second set would you accept that you were the same as someone who scored 50 in the first set?

However a health care policy maker (or an insurance company) may just look at the average and conclude YOU have a 50% chance of dying from CVD by the time you are 80 even if you are that 0 or 100 person. Worse that 50% average is then reinforced by bureaucracy over time which is what I am calling "social bias" i.e. people then expect you to have a 50% chance of dying from CVD by the time you are 80 because a flawed study that relied on extreme averaging says so.

Anyway it's unfair to bring Malc into this as Malc is a sheep and probably immortal. Must be because he's a talking magic sheep.

 

[borofergie]

Anyway it's unfair to bring Malc into this as Malc is a sheep and probably immortal. Must be because he's a talking magic sheep.

To be honest, I don't think he really has diabetes. He just hangs out with us, becuase he thinks it makes him look cool.

 

[noblehead]

I know that a badly-managed type 1 diabetes will cause "complications" (itself a multitude of sins) later in life, but how about a moderately-managed type 1?

I'm talking about myself, I'm 45 and test & inject regularly, but do not lead a strict regime of no beer/fatty foods etc and only exercise intermittently (I used to be very physically fit). I am always failing to drum up the will to be strict about my lifestyle.

As blokes don't live as long as women anyway (usually), would you say that diabetes shortens our lives at all?

John,

This subject has been covered many times before and I remember one member who had type 1 diabetes for 63 years posting a truly inspiring story, here it is:


''I am now 63 years old and was diagnosed with type 1 when I was 8 months old. At that time in history it was recognised that many diabetic children were dying as a result of lack of proper care in their family's. A decision wasmade to open, I believe 4 specialist childrens homes, to teach the children to be able to manage their own diabetes care. I wasa child believed to be at risk and at five (?) years old wasplaced into a home in Kingsdown, nr Deal, Kent, known as St Monica's. It was run by, what was then called the Church of England Children's Society (later to become the Children's Society). It was a lovely caring environment for boys and girls. We used to check our blood sugars over a bunsen burner and we were all on 80 Lente insulin. We were taught to calculate our food on a carbohydrate basis and I have continued that principle ever since. I moved to a different children's home in Salford, again run by the same organisation called St Georges, when In was 11 years old. (There must be many people out there having experience of both homes.) This was a boys only homeand again the insulin regime was 80 Lentefor all the boys. I left at 16 years old, returning to my family home. I have always been a keen sports person and the early cotton wool protections I experienced made me very competitive. I played football up to 51yearsof age, have run several marathons and half marathons andcurrently enjoy cycling and Pilates. I have no health problems, my control is fine, although hypos can occur if I get it wrong after intense exercise but I love my active lifestyle. One ambition I have is to attempt John O'Groats to Lands End on my bike when I retire in 18 months time. Not the longest but I haveenjoyed and continue to enjoy a full and rewarding life.''



No one can say for sure if diabetes will shorten our lives and the only way we can ensure that we live as long as possible is take care of our diabetes by maintaining good bg, bp and cholesterol levels, stopping smoking (if you smoke) and drinking in moderation if you drink. Exercising daily and eating a healthy diet is also paramount and should go a long way to help us in our quest for longevity.

I'm on my 31st year with type 1 and I was talking with someone recently who has had it for 47 years without complications, the advances made in insulin treatments and equipments in recent years have gone along way to help us lead a full, long and active life.

It's never to late John so hope you start to get back on top of things soon, good luck!

 

[viviennem]

Grazer needs to be careful; when his teeth go they'll send him for slaughter. :wink: He'll need to talk very fast then! :lol:

I agree he's magic, though . . .

Viv 8)