Journal article
Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation
The lancet. Diabetes & endocrinology, Vol.11(10), pp.731-742
10/2023
DOI: 10.1016/S2213-8587(23)00223-1
PMCID: PMC7615299
PMID: 37708900
Abstract
The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy.
For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961–2007, median latest follow-up years 1980–2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU.
For participants with diabetes, we observed a linear dose–response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43–2·97) when diagnosed at 30–39 years, 2·26 (2·08–2·45) at 40–49 years, 1·84 (1·72–1·97) at 50–59 years, 1·57 (1·47–1·67) at 60–69 years, and 1·39 (1·29–1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier.
Every decade of earlier diagnosis of diabetes was associated with about 3–4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes.
British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.
Details
- Title: Subtitle
- Life expectancy associated with different ages at diagnosis of type 2 diabetes in high-income countries: 23 million person-years of observation
- Creators
- Emerging Risk Factors CollaborationS KaptogeSRK SeshasaiL SunM WalkerT BoltonS SpackmanF AtaklteP WilleitS BellS BurgessL PennellsS AltayG AssmannY Ben-ShlomoL G BestC BjörkelundD G BlazerH BrennerE J BrunnerG R DagenaisJ A CooperC CooperC J CrespoM CushmanR B D'AgostinoM DaimonL B DanielsR DankerK W DavidsonR T de JonghC DonfrancescoP DucimetierePJM EldersG EngströmI FordI GallacherSJL BakkerU GoldbourtG de La CámaraS GrimsgaardV GudnasonP O HanssonH ImanoJ W JukemaC KabrhelJ KauhanenM KavousiS KiechlM W KnuimanD KromhoutH M KrumholzL H KullerT LaatikainenD A LowlerH E MeyerK MukamalP J NietertT NinomiyaD NitschB G NordestgaardL PalmieriJ F PriceP M RidkerQ SunA RosengrenR RousselM SakuraiV SalomaaB SchöttkerJ E ShawT E StrandbergJ SundströmH TolonenA TverdalWMM VerschurenH VölzkeL WagenknechtR B WallaceS G WannametheeN J WarehamS Wassertheil-SmollerK YamagishiB B YeapS HarrisonM InouyeS GriffinA S ButterworthA M WoodS G ThompsonN SattarJ DaneshE Di AngelantonioR W TippingS RussellM JohansenM P BancksM Mongraw-ChaffinD MaglianoELM BarrP Z ZimmetP H WhincupJ WilleitC LeitnerD A LawlorP ElwoodS E SutherlandK J HuntR M SelmerL L HaheimI AriansenA Tybjaer-HansenR Frikkle-SchmidtA LangstedC Lo NoceB BalkauF BonnetF FumeronD L PablosC R FerroT G MoralesS MclachlanJ GuralnikK T KhawB HolleczekH StockerA NissinenE VartiainenP JousilahtiK HaraldJ M MassaroM PencinaA LyassS SusaT OizumiT KayamaA ChetritJ RothL OrensteinL WelinK SvärdsuddL LissnerD HangeK MehligR S TilvisE DennisonL WestburyP E NormanO P AlmeidaG J HankeyJ HataM ShibataY FurutaM T BomF RuttersM MuilwijkP KraftS LindstromC TurmanM KiyamaA KitamuraY GerberJ T SalonenL N van SchoorE M van ZutphenO MelanderB M PsatyM BlahaI H de BoerR A KronmalG GranditsH-C ShinJ R AlbertorioR F GillumF B HuS HumphriesF Hill- BriggsE VranyM ButlerJ E SchwartzH IsoP AmouyelD ArveilerJ FerrieresR T GansevoortR de BoerL KienekerS TrompetP KearneyB CantinJ P DesprésB LamarcheG LaughlinL McEvoyT AspelundB ThorssonG SigurdssonM TillyM A IkramM DorrS SchipfA M FrettsJ G UmansT AliN SharaG Davey-SmithG CanH YükselU ÖzkanH NakagawaY MorikawaM IshizakiI NjølstadT WilsgaardE MathiesenJ BuringN CookV ArndtD RothenbacherJ MansonL TinkerM ShipleyA G TabakM KivimakiC PackardM RobertsonE FeskensM Geleijnse
- Resource Type
- Journal article
- Publication Details
- The lancet. Diabetes & endocrinology, Vol.11(10), pp.731-742
- DOI
- 10.1016/S2213-8587(23)00223-1
- PMID
- 37708900
- PMCID
- PMC7615299
- NLM abbreviation
- Lancet Diabetes Endocrinol
- ISSN
- 2213-8587
- eISSN
- 2213-8595
- Publisher
- Elsevier Ltd
- Language
- English
- Electronic publication date
- 09/11/2023
- Date published
- 10/2023
- Academic Unit
- Microbiology and Immunology; Infectious Diseases; Epidemiology; Injury Prevention Research Center; Medicine Administration; Internal Medicine; Ophthalmology and Visual Sciences
- Record Identifier
- 9984466697702771
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