Reduced life expectancy in type 2 diabetes seen across all social strata
medwireNews: Type 2 diabetes is associated with reduced life expectancy at almost all ages and levels of socioeconomic status (SES), researchers report.
This suggests the need for preventive and management strategies to be aimed at patients in all social strata and not just deprived groups, they note.
But the team also points out that the reductions in life expectancy associated with type 2 diabetes even at their largest were “smaller than may have been expected from relative risks of mortality associated with type 2 diabetes that we and others have previously reported.”
They found that differences in life expectancy ranged from a significant 5.5 years for women with type 2 diabetes aged 40–44 years in the second most deprived quintile, on the Scottish Index of Multiple Deprivation, to 0.5 years for men with diabetes aged 85–89 years in the second most deprived quintile.
Men aged 80–89 years in the most deprived quintile were the only group with type 2 diabetes that did not have a reduced life expectancy that was significant compared with their peers without diabetes.
The findings were based on information from the Scottish Care Information – Diabetes database for 272,597 patients with type 2 diabetes and 2.75 million individuals without, all aged 40–89 years.
“While persistence of a life expectancy deficit across the full range of deprivation levels is confirmed, it is clear that the magnitude of the differences in life expectancy between those with and without diabetes is not uniform,” the team comments in Diabetologia.
There was a marked distinction according to sex, they explain, with diabetes-related differences in life expectancy generally smaller in men than women, especially at the more deprived ends of the SES spectrum.
Life expectancy was lower for those in the most versus the least deprived fifths of the population for almost all age groups, regardless of type 2 diabetes status, but the greatest differences were seen among those in the younger age groups and among men without rather than with type 2 diabetes.
“[T]he SES-related difference in mortality risk observed in the ‘general’ male population appears to be attenuated in those with type 2 diabetes,” say Sarah Wild (The University of Edinburgh, UK) and colleagues.
The finding “reinforces the message that for men with diabetes (as for many other clinical entities), improvement of mortality prospects will demand not only effective management of the condition but also the development of more general strategies to reduce inequality,” the researchers comment.
By contrast, for women, the SES-related mortality risk across most of the different age groups was similar in those with and without type 2 diabetes.
The researchers conclude that “increasing prevalence of diabetes will contribute to slower improvements in population life expectancy over time,” and an increasing prevalence in young people “can be expected to have a particularly detrimental effect on life expectancy.”
By Lucy Piper
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