SAN DIEGO – Life expectancy of patients with type 1 diabetes has improved dramatically since 1950, results from a long-term prospective study have shown.
According to the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study, life expectancy at birth for those diagnosed with type 1 diabetes during 1965-1980 was 68.8 years, or about 4 years less than that of a comparable cohort of the U.S. general population, while life expectancy for those diagnosed during 1950-1964 was 53.4 years, or about 18 years less than that of a comparable cohort of the general population.
“Individuals with childhood-onset diabetes do not represent a major insurance risk and should be minimally penalized, if at all, in terms of life insurance and other mortality-based decisions,” Dr. Trevor J. Orchard, professor of epidemiology, pediatrics, and medicine at the University of Pittsburgh, said at the meeting.
The objective of the current study was to compare the life expectancy of two different cohorts of patients enrolled in the Pittsburgh EDC Study, a prospective study of childhood-onset type 1 diabetes. Of the 933 patients, 390 were diagnosed or seen within 1 year of diagnosis at Children's Hospital of Pittsburgh during 1950-1964 (cohort 1), while 543 were diagnosed or seen within a year of diagnosis during 1965-1980 (cohort 2). Half of the participants were female, and their mean age at diagnosis was 8 years. All were followed through 2009.
To ascertain mortality, the researchers used death certificates and hospital, autopsy, and coroner reports.
Dr. Orchard reported that the 30-year mortality for patients in cohort 1 was 35% compared with 12% for those in cohort 2. Similarly, the life expectancy at birth for those in cohort 1 was estimated to be 53.4 years compared with 68.8 years for those in cohort 2, a difference of about 15 years. Both differences were significant. This persisted regardless of sex or pubertal status at diagnosis of diabetes.
The life expectancy of cohort 2 is 3.6 years less than that estimated for a comparable cohort of the U.S. general population (72.4 years), Dr. Orchard said, while the life expectancy of cohort 1 is about 18 years less than that of a comparable cohort of the general population (71.5 years).
Reasons for the improvement in life expectancy between the two cohorts are multifactorial, he said, including the development of blood glucose self-monitoring and the use of the hemoglobin A1c test, which was not available in cohort 1.
Dr. Orchard is a consultant for AstraZeneca and Abbott, received research support from VeraLight, and has inherited Bristol-Myers Squibb stock.
To view an interview with Dr. Orchard, scan this using your smartphone.
'Individuals with childhood-onset diabetes do not represent a major insurance risk.'
Source DR. ORCHARD