JAMA sub-issue: Controlling these "four indicators" can make diabetics live 10 years longer!

Exciting good news! Recently, a study published in the authoritative journal JAMA Network Open found that patients with diabetes who control the four indicators of "glycation, weight, blood pressure and low-density lipoprotein cholesterol" may prolong their life by 10 years! "I love to eat but avoid it.
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Is it really worth giving up a lot of 'fun' in life for the sake of diabetes?" This question, which has been widely haunted in the minds of diabetic patients, now has a clear answer
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"It's worth it, it's worth it!" "Saccharification" up to standard, at least 3 years of life extension! "Glycation" is glycated hemoglobin (HbA1c).
Studies have shown that reducing "glycation" from a higher level to the target range can extend the life expectancy of type 2 diabetes patients by more than 3 years, and the higher the level of "glycation" at the beginning of control, The longer lifespan is more pronounced
.

Figure 1 Impact of risk indicators on life expectancy in patients with T2DM For example, controlling HbA1c from 9.
9% to 7.
7% increased life expectancy by an average of 3.
4 years
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So, lower "glycation" is better? it's not true! It is particularly emphasized here that after the "glycation" is reduced to the recommended target, the increase in lifespan decreases, and the risk of hypoglycemia may increase
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And studies have shown that too low "glycation" levels can increase the risk of death
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Therefore, "saccharification" can reach the standard, and do not pursue too low levels
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"Weight" up to standard, can prolong life by 2 to 4 years! Obesity is not only a disease, but also the source of all diseases
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If diabetic patients are overweight or obese, they must lose weight and return to a healthy weight range (BMI 18.
5~23.
9 kg/m^2) as much as possible
.

 The study showed that if obese patients could reduce their BMI from 41.
4 to 33.
0, 28.
6 and 24.
3, their average life expectancy would increase by 2.
0, 2.
9 and 3.
9 years, respectively
.

"Blood pressure" up to standard, can prolong life by about 2 years! Studies have shown that when systolic blood pressure (high blood pressure) is reduced from 160.
4 mmHg to 114.
1 mmHg, the average life expectancy increases by 1.
9 years; when it is reduced to 139.
1 mmHg or 128.
2 mmHg, life expectancy can also increase on average by 1.
5 and 1.
1 years
.

Although the effect of systolic blood pressure on life expectancy appears to be less pronounced compared to HbA1c and body weight, this does not mean that blood pressure control is not important
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The current antihypertensive drugs have become one of the very important and efficient means to prevent cardiovascular diseases due to their low cost and convenient administration
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Taking one pill a day can increase your lifespan by nearly 2 years, which is also a very cost-effective thing
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"Blood lipids" up to the standard can prolong life by more than half a year! The level of LDL-C (low-density lipoprotein cholesterol) on the test sheet may also affect the life expectancy of people with diabetes
.

 The study showed that when LDL-C was lowered from 146.
2 mg/dL to 107 mg/dL, 84.
0 mg/dL and 59 mg/dL, an increase in life expectancy of 0.
5, 0.
7 and 0.
9 years could be obtained, respectively
.

Act early, benefit early! In addition, the results of this study also showed that the younger the age at the start of the control, the greater the impact on life expectancy
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Table 1 Age, sex, risk factors, and prolongation of life expectancy.
For example, a 55-year-old man with a BMI of 35 kg/m2, a systolic blood pressure of 160 mmHg, an HbA1c level of 8%, and an LDL-C of 130 mg/dL: change his BMI from 35 kg Reducing BMI to 30 kg/m2 increases life expectancy by 1.
4 years; however, for a 71-year-old male with all other measures, reducing BMI to 30 kg/m2 increases only 0.
6 years
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This underscores the importance of early control of these risk factors
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At the same time, when the benefit of improving these indicators is limited, elderly patients may need to balance quality of life and treatment intensity to set more reasonable goals
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