Lifetime risk up to 60%! The Lancet sub-journal studies more than 1.6 billion people: How much does the diagnosis of diabetes affect life expectancy?

Recently, The Lancet Diabetes & Endocrinology, a sub-journal of The Lancet, published a blockbuster research result
.
Based on population data from 23 different countries and regions, the study analyzed changes in the lifetime risk of diabetes from 2005 to 2019, the life expectancy of patients, and the
number of years of life loss.

The analysis data showed that the lifetime risk of diabetes in different countries and regions included in the study ranged
from 16.
3% to 59.
6%.
For young people with type 2 diabetes (age 20 years confirmed), life expectancy for men and women is 43.
7 to 59.
2 years and 54.
2 years to 64.
1 years
, respectively.
In addition, the loss of life caused by type 2 diabetes can range from 2.
5 to 12.
9 years per year
.

Screenshot credit: The Lancet Diabetes & Endocrinology

The current multi-country, population-based study aims to assess the lifetime risk of type 2 diabetes in different countries and regions with high levels of economic development, the life expectancy of people with or without type 2 diabetes, and the number
of years of life loss in people with type 2 diabetes.
A total of 23 countries or regions were included in the study
.
These countries and regions include: Australia, Austria, Canada, Denmark, Finland, France, Germany, Hong Kong, Hungary, Israel, Italy, Japan, Latvia, Lithuania, the Netherlands, Norway, Scotland, Singapore, South Korea, Spain, Taiwan, the United Kingdom and the United States
.

In all study cohorts in 23 countries and territories (total human-year 1.
577 billion; total population sample size 1.
685 billion), data for participants date back to 2005 as early as 2005 and as recent as 2019
.
Overall, there were 138 million people with type 2 diabetes in these study cohorts; 5,119,600 new confirmed cases of type 2 diabetes; and 4,007,100 deaths
in people with type 2 diabetes.
In addition, there were 1.
547 billion non-type 2 diabetic patients and 0.
12 billion non-type 2 diabetic deaths in these cohorts
.

Lifetime risk of diabetes: 16.
3% to 59.
6%.

The results of the study showed that between 2015 and 2016, the prevalence of diabetes in Singaporean men aged ≥ 85 years reached the peak of the current study (45.
8%)
.
The lifetime risk of diabetes varies greatly between countries and regions
.
For example, between 2015 and 2016, the lifetime risk of diabetes in the male population in Singapore was as high as 59.
6%; In contrast, between 2018 and 2019, the lifetime risk of diabetes in the Scottish female population was as low as 16.
3%.

Comparing lifetime risk at different time points between 2005 and 2019, the analysis data showed that the lifetime risk was reduced in both gender populations in the vast majority of countries and regions in the study during the same interval period (5 years), with the highest reduction in the male population in the United States, reaching 20.
9% (from 54.
0% in 2009-2010 to 33.
1% in 2014-2015).

In addition, in the same country or region, men generally have a higher lifetime risk than women
.

Life expectancy in young diabetics

In terms of life expectancy, the life expectancy of diabetics in Japan was the highest between 2017 and 2018 (59.
2 years for men and 64.
1 years for women if the age of diagnosis is 20 years).

In contrast, among men, Lithuania has the lowest life expectancy among diabetics, at 43.
7 years (20 years if age of diagnosis) between 2013 and 2014, and among women, the life expectancy of diabetics in Latvia is the lowest, at 54.
2 years in 2010-2011 (20 years if the age of diagnosis).

With the exception of Spain and Scotland, life expectancy for people with type 2 diabetes in all other countries and regions in the study increased
over time.
For example, between "2009-2014" and "2014-2015," life expectancy among diabetic men in the U.
S.
increased by nearly 2.
3 years
.
The paper notes that as the average age of diabetes in the population increases, the effect of the disease in reducing life expectancy is weakened
.

Image source: 123RF

Life loss years: 2.
5 years to 12.
9 years

In terms of years of life loss, the current study observes that the number of years of life loss in diabetic people in Israel is the highest in the current study (if men are diagnosed at 20 years old, the number of years of life loss can be as high as 12.
9 years).

In addition, between 2015 and 2016, Latvia had the lowest number of years of life loss for men with diabetes (2.
5 years), while from 2011 to 2012, Finland had the lowest number of years of life loss for women with diabetes (3.
1 years
).

It is worth noting that with the passage of time, the number of years of life expectancy lost by diabetic people in some countries and regions has shown a downward trend, while other countries and regions have shown an increasing trend
.
Among them, the country with the largest decline in the number of years of loss of life expectancy for men is the United States, which has decreased by 2.
7 years from "2009-2010" to "2014-2015" (if the age of diagnosis is 20 years), while the largest decline in the number of years lost in female life expectancy is Latvia, which has decreased by 1.
5 years from "2010-2011" to "2015-2016" (if the age of diagnosis is 20 years).

The results of the sensitivity analysis showed that among the different statistical indicators of the disease, the incidence of diabetes had the most significant impact on the lifetime risk of patients; Changes in disease mortality and relative risk of death will have a more direct impact on the number of years lost in life and the outcome of life expectancy
.

Summary

The authors emphasize that the results of this analysis suggest that in the vast majority of countries and regions covered by the current study, the lifelong risk of type 2 diabetes decreases over time, which is mainly related
to the current decline in the incidence of diabetes in these countries and regions.
Another important finding is that although the lifetime risk of diabetes is declining in the vast majority of countries and regions in the study, there are still many countries and regions where the lifetime risk is still greater than 30% (or even partly higher than 50%)
.

Overall, in these countries and regions, although the lifetime risk of diabetes is declining at the individual level and the life expectancy of the population is improving, the overall disease burden of type 2 diabetes is still extremely unpromising
.