Type 1 Diabetes Linked To Lower Life Expectancy
HealthDay Reporter today lose more than a decade of life to the chronic disease, despite improved treatment of both diabetes and its complications, a new Scottish study reports. Men with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years, according to a report published in the Jan. 6 issue of the Journal of the American Medical Association. The findings "provide a more up-to-date quantification of how much type 1 diabetes cuts your life span now, in our contemporary era," said senior author Dr. Helen Colhoun, a clinical professor in the diabetes epidemiology unit of the University of Dundee School of Medicine in Scotland. Diabetes' impact on heart health appeared to be the largest single cause of lost years, according to the study. But, the researchers also found that type 1 diabetics younger than 50 are dying in large numbers from conditions caused by issues in management of the disease -- diabetic coma caused by critically low blood sugar, and ketoacidosis caused by a lack of insulin in the body. "These conditions really reflect the day-to-day challenge that people with type 1 diabetes continue to face, how to get the right amount of insulin delivered at the right time to deal with your blood sugar levels," Colhoun said. A second study, also in JAMA, suggested that some of these early deaths might be avoided with intensive blood sugar management. In that paper, researchers reduced patients' overall risk of premature death by about a third, compared with diabetics receiving standard care, by conducting multiple blood glucose tests throughout the day and constantly adjusting insulin levels to hit very specific blood sugar levels. "Across the board, indiv Continue reading >>
Life Expectancy For Type 1 Diabetes
New study shows recent improvement in years of life lost. With minimal studies to evaluate the impact of type 1 diabetes on life expectancy, studies have been developed to retrospectively look at the effects of diabetes on mortality. Diabetes was also compared to other disease states and causes that had an influence on years of life lost (YLL). The YLL of patients with type 1 diabetes and patients with other disease states were compared to those of the general healthy population. This autoimmune disorder accounts for 10% of all Americans diagnosed with diabetes, and the ability to prevent the development of type 1 diabetes is minimal. Causes have been linked to genetics, and viral infections such as mumps, rubella, cytomegalovirus, measles, influenza, encephalitis, polio, or Epstein-Barr virus. In a study conducted on Australians with type 1 diabetes between the years of 1997 and 2010, researchers looked at the estimated YLL of the type 1 diabetic patients compared to the general public. Researchers used the Chiang method to estimate life expectancy and Arriaga’s method to estimate the impact of age-specific and cause-specific mortalities. Results showed no disparity in terms of YLL from type 1 diabetes in women vs. men. When the YLL was organized into two groups, 1997-2003 and 2004-2010, the 2004-2010 groups showed improvement in life expectancies of 1.9 years in men and 1.5 years in women. Overall, over the time period of the study, patients with type 1 diabetes had a life expectancy of 12.2 years less than the general population. The majority of the YLL was attributed to endocrine and metabolic diseases that occurred between the ages of 10-39, and circulatory diseases that occurred after the age of 40. Medical advances over the years may account for the YLL improve Continue reading >>
Type 1 Diabetes Through The Life Span: A Position Statement Of The American Diabetes Association
Incidence and Prevalence of Type 1 Diabetes The exact number of individuals with type 1 diabetes around the world is not known, but in the U.S., there are estimated to be up to 3 million (1). Although it has long been called “juvenile diabetes” due to the more frequent and relatively straightforward diagnosis in children, the majority of individuals with type 1 diabetes are adults. Most children are referred and treated in tertiary centers, where clinical data are more readily captured. The SEARCH for Diabetes in Youth study estimated that, in 2009, 18,436 U.S. youth were newly diagnosed with type 1 diabetes (12,945 non-Hispanic white, 3,098 Hispanic, 2,070 non-Hispanic black, 276 Asian-Pacific Islander, and 47 American Indian) (2). Worldwide, ∼78,000 youth are diagnosed with type 1 diabetes annually. Incidence varies tremendously among countries: East Asians and American Indians have the lowest incidence rates (0.1–8 per 100,000/year) as compared with the Finnish who have the highest rates (>64.2 per 100,000/year) (3). In the U.S., the number of youth with type 1 diabetes was estimated to be 166,984 (4). The precise incidence of new-onset type 1 diabetes in those over 20 years of age is unknown. This may be due to the prolonged phase of onset and the subtleties in distinguishing the different types of diabetes. In one European study of adults aged 30–70 years, ∼9% tested positive for GAD antibodies (GADA) within 5 years of a diabetes diagnosis, consistent with other studies (5). Adults with type 1 diabetes often receive care in primary care settings rather than with an endocrinologist. Unlike the consolidated care seen in pediatric diabetes management, the lack of consolidated care in adults makes incidence and prevalence rates difficult to characterize, an Continue reading >>
Type 1 Diabetes
A person with type 1 diabetes cannot produce insulin themselves, so needs to take insulin to manage their blood sugar levels. Type 1 diabetes is known as an autoimmune condition, because the body's defences - the immune system - wrongly attacks the cells in the pancreas responsible for making insulin. Although the condition usually appears before the age of 40 and more than half the people with type 1 are diagnosed under the age of 15, type 1 diabetes may occur at any age, according to Diabetes UK. Type 1 diabetes is less common than type 2 diabetes and accounts for around 10% of the UK's 3.5 million people diagnosed with diabetes, according to Diabetes UK. Insulin and type 1 diabetes Normally, the hormone insulin is secreted by the pancreas. When you eat a meal, sugar (glucose) from food stimulates the pancreas to release insulin. The amount that is released is proportional to the amount that is required by the size of that particular meal. Insulin's main role is to help move certain nutrients - especially sugar - into the cells of the body's tissues. Cells use sugars and other nutrients from meals as a source of energy to function. The amount of sugar in the blood decreases once it enters the cells. Normally that signals the beta cells in the pancreas to reduce the amount of insulin secreted so that you don't develop low blood sugar levels ( hypoglycaemia). But the destruction of the beta cells that occurs with type 1 diabetes throws the entire process into disarray. In people with type 1 diabetes, sugar isn't moved into the cells because insulin is not available. When sugar builds up in the blood instead of going into cells, the body's cells are starved of nutrients. This means other systems in the body must provide energy for many important bodily functions. As a re Continue reading >>
Type 1 Diabetes Still Shortens Life Span, Scottish Study Finds
Type 1 diabetes still shortens life span, Scottish study finds Type 1 diabetes still shortens life span, Scottish study finds BMJ 2015; 350 doi: (Published 07 January 2015) Cite this as: BMJ 2015;350:h59 Despite major medical advances over the past three decades, a 20 year old woman with type 1 diabetes can still expect to live 13 years less than someone without the condition, a large Scottish study has concluded.1 For men the estimated life expectancy loss is 11 years. The prospective cohort study, published in JAMA, found that even in the absence of renal complications mortality from cardiovascular disease remained significantly more in people with type 1 diabetes than in the population without diabetes. Intensive insulin treatment is now the standard of care, and over the past 30 years significant advances have been made in insulin delivery and glucose monitoring that help in the management of type 1 diabetes. Yet for many people with type 1 diabetes glycaemic control remains suboptimal, and acute and chronic complications from diabetes persist, reducing life expectancy. Researchers from Dundee University used a national registry of patients Continue reading >>
Type 1 Diabetes Mellitus In Children
What is type 1 diabetes? Diabetes is a condition in which the body can't make enough insulin, or can't use insulin normally. Type 1 diabetes is an autoimmune disorder. The body's immune system damages the cells in the pancreas that make insulin. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. It can also cause symptoms such as tiredness. Type 1 diabetes mellitus is a long-term (chronic) condition. It may start at any age. Only 5% of people with diabetes have type 1. Insulin from the pancreas must be replaced with insulin injections or an insulin pump. There are two forms of type 1 diabetes: Immune-mediated diabetes. This is an autoimmune disorder in which the body's immune system damages the cells in the pancreas that make insulin. This is the most common kind of type 1 diabetes. Idiopathic type 1. This refers to rare forms of the disease with no known cause. What causes type 1 diabetes? The cause of type 1 diabetes is unknown. Researchers think some people inherit a gene than can cause type 1 diabetes if a trigger such as a virus occurs. Who is at risk for type 1 diabetes? A child is more at risk for type 1 diabetes if he or she has any of these risk factors: A family member with the condition Caucasian race Being from Finland or Sardinia Is age 4 to 6, or 10 to 14 What are the symptoms of type 1 diabetes? Type 1 diabetes often appears suddenly. In children, type 1 diabetes symptoms may be like flu symptoms. Symptoms can occur a bit differently in each child. They Continue reading >>
Type 1 Diabetes Through The Life Span: A Position Statement Of The Americandiabetes Association.
1. Diabetes Care. 2014 Jul;37(7):2034-54. doi: 10.2337/dc14-1140. Type 1 diabetes through the life span: a position statement of the AmericanDiabetes Association. Chiang JL(1), Kirkman MS(2), Laffel LM(3), Peters AL(4); Type 1 DiabetesSourcebook Authors. Collaborators: Algothani N, Allweiss P, Anderson BJ, Brown FM, Chase H, ClarkeWL, Colberg SR, Dungan K, Edelman S, Funnell MM, Gitelman SE, Goebel-Fabbri AE,Gonzalez JS, Greenbaum CJ, Haller MJ, Hawkins K, Higgins LA, Hirsch IB, Hsu WC,Ismail H, Crismond Jackson C, James-Todd T, Klingensmith GJ, Klonoff DC,Korytkowski M, Maahs D, Mahmud H, Munshi MN, Orchard T, Perkins BA, Pettus JH,Posselt AM, Riddell MC, Seaquist ER, Silverstein J, Siminerio LM, Stock P,Tamborlane WV, Umpierrez GE, Washington R, Wolfsdorf JI, Wolpert H, Wyckoff JA,Zacharatos MZ. (1)American Diabetes Association, Alexandria, VA [email protected]. (2)Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. (3)Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center; Department of Pediatrics, Harvard Medical School, Boston, MA. (4)Division of Endocrinology, Keck School of Medicine of the University of Southern California, Los Angeles, CA. Continue reading >>
Ada: Targets Tightened For Kids' Type 1 Diabetes
ADA: Targets Tightened for Kids' Type 1 Diabetes Please click the bottom right corner for full screen. Click here for full ADA 2014 video coverage. by Crystal Phend Crystal Phend, Senior Staff Writer, MedPage Today This article is a collaboration between MedPage Today and: Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. A position statement of the ADA summarizes available data specific to the comprehensive care of individuals with type 1 diabetes. Note that recommended A1c targets are higher for those under 18 years and healthy older adults than adults. SAN FRANCISCO -- Tiered treatment targets in pediatric type 1 diabetes have been eliminated by the American Diabetes Association in favor of a single, lower goal. The guidelines now recommend under 7.5% as the hemoglobin A1c target for all patients under age 19, the association's Jane L. Chiang, MD , reported here at its annual meeting and online in Diabetes Care. Previously, the targets were under 8.5% for kids younger than 6 years of age, 8.0% for those 6 to 12, and 7.5% for teens. The shift reflected lower risk of hypoglycemia with newer therapies, greater understanding of the CNS risk of hyperglycemia in children, and desire for a unified target, noted Lori Laffel, MD, MPH , of Joslin Diabetes Center in Boston and a co-author on the position statement. She cited recent evidence from MRI scans that hyperglycemia and glycemic variability correlate with changes in the central nervous system white matter. The International Society for Pediatric and Adolescent Diabetes and the International Diabetes Federation have been recommending the single, lower pediatric target for years. An Continue reading >>
Type 1 Diabetes May Cut Life Span, But Intensive Treatment Can Help Close The Gap
People with type 1 diabetes may have a shorter life expectancy than their peers, but intensive treatment may help offset that risk, say two separate new studies. In the first study, published in JAMA, Shona J. Livingstone of the University of Dundee in Scotland and her colleagues compared the life expectancy of Scottish men and women ages 20 and older who had type 1 diabetes to a group of adults without the condition. Life expectancy after age 20 was an additional 46.2 years among men with type 1 diabetes, but 57.3 years among men without the condition, an estimated loss of 11.1 years. Find the Best Diabetes Blogs of the Year » The life expectancy after age 20 for women with type 1 diabetes was an additional 48.1 years, compared to 61 years among women without it, an estimated loss of 12.9 years for women with diabetes. In the general population without type 1 diabetes, 76 percent of men and 83 percent of women lived to age 70, compared with 47 percent of men and 55 percent of women with type 1 diabetes. The study also showed that even patients with type 1 diabetes who still had good kidney function had reduced life expectancy. Heart Disease, Diabetic Comas Are Common Causes of Death Dr. Helen Colhoun, a professor of public health at the University of Dundee and a co-author of the study, told Healthline that heart disease, heart attacks, and diabetic comas were responsible for the largest percentage of the estimated loss in life expectancy for patients younger than 50. Colhoun said, “The data are good news for people with type 1 diabetes. They show much better average life expectancy than older reports from other countries. At the same time, they also show that further work needs to be done to get to a goal of no reduction in life span. These data emphasize that effo Continue reading >>
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Diabetes Through The Life Span: Psychological Ramifications For Patients Andprofessionals
From Research to Practice / Lessons From the UKPDS Psychological Ramifications for Patients and Professionals Wendy Satin Rapaport, LCSW, PsyD, Rebecca Taylor Cohen, MA, and Like all chronic and progressive problems, including normal aging, diabetes has social, psychological, emotional, and spiritual aspects that demand attention. Patients with type 2 diabetes and their health care providers must find their common ground to meet these challenges. Grief and shame at growing older and having medical problems afflict everyone, and denial of these feelings must be recognized and overcome. If not, patients will ignore or resist direction on lifestyle or medications. Psychological resistance to using insulin is a notable example. Providers' self-awareness and comfort with their similar feelings, empathy with patients' distress, ability to influence incremental change and place setbacks into perspective, and skill in supporting patients' positive efforts can strongly influence the process of treatment. Success with modern therapies still depends on individualization of treatment, patient empowerment, and the competency of the professional relationship. The United Kingdom Prospective Diabetes Study (UKPDS)1 has shown that the risk of developing diabetes complications grows over time, but with appropriate and progressive treatment this risk can be greatly reduced. Taking control of diabetes can make a difference for type 2 diabetes patients. These findings may help demystify this disorder for patients, help reduce their feelings of anxiety and blame that come from dealing with an unknown and misunderstood entity, and allow them to develop a sense of control. The question now is how health-care providers can understand and use the study's results to enhance diabetes management a Continue reading >>
Treatment Of Type 1 Diabetes: Synopsis Of The 2017 American Diabetes Association Standards Of Medical Care In Diabetes Free
Abstract Description: The American Diabetes Association (ADA) annually updates Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards of Care, the ADA Professional Practice Committee did MEDLINE searches from 1 January 2016 to November 2016 to add, clarify, or revise recommendations on the basis of new evidence. The committee rated the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience. The Standards of Care were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions. Recommendation: This synopsis focuses on recommendations from the 2017 Standards of Care about monitoring and pharmacologic approaches to glycemic management for type 1 diabetes. The American Diabetes Association (ADA) first released its practice guidelines for health professionals in 1989. The Standards of Medical Care in Diabetes have since provided an extensive set of evidence-based recommendations that are updated annually for the diagnosis and management of patients with diabetes. The 2017 Standards of Care cover all aspects of patient care (1); this guideline synopsis focuses on monitoring and pharmacologic approaches for patients with type 1 diabetes. Guideline Development and Evidence Grading Monitoring Glycemia in Type 1 Diabetes Glycemic Goals: Recommendations Pharmacologic Therapy for Type 1 Diabetes: Recommendations Continue reading >>
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Diabetes Life Expectancy
Tweet After diabetes diagnosis, many type 1 and type 2 diabetics worry about their life expectancy. Death is never a pleasant subject but it's human nature to want to know 'how long can I expect to live'. There is no hard and fast answer to the question of ‘how long can I expect to live’ as a number of factors influence one’s life expectancy. How soon diabetes was diagnosed, the progress of diabetic complications and whether one has other existing conditions will all contribute to one’s life expectancy - regardless of whether the person in question has type 1 or type 2 diabetes. How long can people with diabetes expect to live? Diabetes UK estimates in its report, Diabetes in the UK 2010: Key Statistics on Diabetes[5], that the life expectancy of someone with type 2 diabetes is likely to be reduced, as a result of the condition, by up to 10 years. People with type 1 diabetes have traditionally lived shorter lives, with life expectancy having been quoted as being reduced by over 20 years. However, improvement in diabetes care in recent decades indicates that people with type 1 diabetes are now living significantly longer. Results of a 30 year study by the University of Pittsburgh, published in 2012, noted that people with type 1 diabetes born after 1965 had a life expectancy of 69 years.[76] How does diabetic life expectancy compare with people in general? The Office for National Statistics estimates life expectancy amongst new births to be: 77 years for males 81 years for females. Amongst those who are currently 65 years old, the average man can expect to live until 83 years old and the average woman to live until 85 years old. What causes a shorter life expectancy in diabetics? Higher blood sugars over a period of time allow diabetic complications to set in, su Continue reading >>
T1dm Through The Life Span: Ada Position Statement
Family issues in type 1 diabetes management Developing a trusting relationship or bond with primary caregiver(s) Avoiding extreme fluctuations in blood glucose levels Sharing the burden of care to avoid parent burnout Developing a sense of mastery and autonomy Avoiding extreme fluctuations in blood glucose levels due to irregular food intake Limit-setting and coping with toddler's lack of cooperation with regimen Preschooler and early elementary school (37 years) Developing initiative in activities and confidence in self Reassuring child that diabetes is no one's fault Coping with unpredictable appetite and activity Educating other caregivers about diabetes management Positively reinforcing cooperation with regimen Trusting other caregivers with diabetes management Developing skills in athletic, cognitive, artistic, and social areas Making diabetes regimen flexible to allow for participation in school or peer activities Maintaining parental involvement in insulin and blood glucose management tasks while allowing for independent self-care for special occasions Consolidating self-esteem with respect to the peer group Child learning short- and long-term benefits of optimal control Continuing to educate school and other caregivers Age and characteristics of onset of diabetes (e.g., DKA, asymptomatic laboratory finding) Eating patterns, physical activity habits, nutritional status, and weight history Whether or not patient wears medical alert identification Diabetes education history; health literacy assessment Review of previous insulin treatment regimens and response to therapy (A1C records), treatment preferences, and prior difficulty with therapies Current treatment of diabetes, including medications and medication adherence, meal plan, physical activity patterns, and r Continue reading >>
M A N A G E M E N T A N D T R E A T M E N T O F
This care process model (CPM) was developed by Intermountain Healthcare’s Pediatric Clinical Specialties Program. It provides guidance for identifying and managing type 1 diabetes in children, educating and supporting patients and their families in every phase of development and treatment, and preparing our pediatric patients to transition successfully to adulthood and adult diabetes self-management. This CPM is based on guidelines from the American Diabetes Association (ADA), particularly the 2014 position statement Type 1 Diabetes Through the Life Span, as well as the opinion of local clinical experts in pediatric diabetes.ADA1,CHI Pediatric Type 1 Diabetes C a r e P r o c e s s M o d e l F E B R U A R Y 2 0 1 7 2 0 17 U p d a t e Why Focus on PEDIATRIC TYPE 1 DIABETES? Diabetes in childhood carries an enormous burden for patients and their families and represents significant cost to our healthcare system. In 2008, Intermountain Healthcare published the first CPM on the management of pediatric diabetes with the overall goal of helping providers deliver the best clinical care in a consistent and integrated way. What’s new: • Separate CPMs for type 1 and type 2 pediatric diabetes to promote more- accurate diagnosis and more-focused education and treatment. • Updated recommendations for diagnostic testing, blood glucose control, and follow-up care specifically related to pediatric type 1 diabetes. • A more comprehensive view of treatment for pediatric type 1 diabetes — one that emphasizes psychosocial wellness for patient and family and lays a foundation for better health over the lifespan. • Information and tools to support pediatric type 1 diabetes care by nonspecialist providers — important for coping with the ongoin Continue reading >>
Life Expectancy 'not Reduced' By Intensive Type 1 Diabetes Treatment
Although the recommended standard of care, it has yet to be established whether intensive diabetes therapy affects mortality in type 1 diabetes patients. A new study, however, has found an association between intensive treatment and a modestly lower all-cause rate of death. Researchers from the University of Pittsburgh, PA, followed type 1 diabetes patients for an average of 27 years. Among these patients, receiving intensive treatment with the aim of reducing blood sugar levels to a nondiabetic range was linked to a slight reduction in mortality compared with conventional treatment. While the effect of intensive diabetes therapy on the mortality of people with type 1 diabetes had not been established, previous research has found that the reduction of blood sugar toward the nondiabetic range in type 2 diabetes patients does not consistently lead to a reduction in mortality. Type 1 diabetes is a condition whereby the body does not produce the insulin required to convert sugars, starches and other foods into energy. With type 2 diabetes, the body does not utilize the insulin that is produced properly - also referred to as insulin resistance. According to the American Diabetes Association (ADA), 29.1 million Americans - around 9.3% of the population - had diabetes in 2012. This figure had increased from 25.8 million (8.3%) in 2010. Diabetes is the 7th leading cause of death in the US. Other research suggests that type 1 diabetes patients may have shorter life expectancies than the general population. A recent Scottish population study, published in JAMA, reports that men with type 1 diabetes have an average life expectancy 11 years lower than the general public. Women with type 1 diabetes at the same age have a life expectancy 13 years lower than the general average. Inten Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Can You Die from Diabetes? Type 1 and Type 2 Life Expectancy
- Diabetes and life expectancy: What effect does type 2 diabetes have?
