Type 1 diabetes death rate falls
Death rates have dropped significantly in people with type 1 diabetes.
Type 1 diabetes (or insulin-dependent diabetes) is an autoimmune disease that causes the body's immune system to mistakenly attack the body's insulin-producing cells. As a result, people with type 1 diabetes make little or no insulin, and must rely on lifelong insulin replacement either through injections or tiny catheter attached to an insulin pump. Insulin is a hormone that allows the body to use blood sugar.
Insulin replacement therapy isn't as effective as naturally-produced insulin, however. People with type 1 diabetes often have blood sugar levels that are too high or too low, because it's difficult to predict exactly how much insulin one will need. When blood sugar levels are too high due to too little insulin, it causes damage that can lead to long term complications, such as high risk of kidney failure and heart disease. On the other hand, if one has too much insulin, blood sugar levels can drop dangerously low, potentially leading to coma or death. These factors explain why type 1 diabetes has long been associated with a significantly higher risk of death, and a shortened life expectancy.
However, numerous improvements have been made in type 1 diabetes management during the past 30 years, including the advent of blood glucose monitors, insulin pumps, newer insulins, better medications to prevent complications and most recently continuous glucose monitors.
To assess whether or not these advances have had any effect on life expectancy - researchers reviewed data from a type 1 diabetes registry in America. The registry contained information on 1,043 people under the age of 18 years at the time they were diagnosed with type 1 diabetes. The children were sorted into three groups based on the year of their diagnosis: 1965 to 1969, 1970 to 1974 and 1975 to 1979. As of January 2008, 279 of the study participants had died, a death rate that is 7 times higher than would be expected in the general population.
When the researchers broke the mortality rate down by the time of diagnosis, they found that those diagnosed later had a much improved mortality rate. The group diagnosed in the 1960s had a 9.3 times higher mortality rate than the general population, while the early 1970s group had a 7.5 times higher mortality than the general population. For the late 1970s group, mortality had dropped to 5.6 times higher than the general population.
And some groups, such as women, continue to have disproportionately higher mortality rates: women with type 1 diabetes are 13 times more likely to die than are their female counterparts without the disease. But it isn't clear why women have higher-than-expected mortality. Previous research has shown that women with diabetes lose their innate protection against heart disease, similar to the loss sustained in postmenopausal phases of life but it's not clear how diabetes causes this loss.
This study shows that diabetes care has improved in many ways over the last couple of decades, and as a result people with diabetes are living longer now. Managing and taking good care of diabetes is the surest way to reduce the risk of developing complications later in life. The encouraging thing is that, given good diabetes control, one can have a near-normal life expectancy.
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