diabetestalk.net

Type 1 Diabetes Survival Rate

5 Surprising Type 1 Diabetes Statistics

5 Surprising Type 1 Diabetes Statistics

To be diagnosed with Type 1 diabetes is to become your own personal medical professional. Sometimes I think a diagnosis should come with a medical degree, because we have to learn so much about diabetes so quickly. But even if you’ve been managing diabetes for a long time like I have, every now and then, you still come across new information that surprises you. Here are five surprising type 1 diabestes statistics you may not have known: 1. The Number of Children Diagnosed T1 in the United States is Virtually the Same Number as the Number of Adults. This is surprising, because so many people still think of T1 as “juvenile diabetes.” The name was changed, in part, to reflect the reality, that Type 1 diabetes can happen just as often in a young adult as a child. Hence, according to the Juvenile Diabetes Research Foundation, the number of children diagnosed T1 is over 15,000. Same for the diagnosed adults. And overall, of course, most people who have “juvenile diabetes” are adults – 85 percent. 2. A Majority of People with Diabetes Don’t Make Use of Technology That Can Help. A recent study presented at a joint meeting of the International Society of Endocrinology and the Endocrine Society found that nearly 70 percent of us don’t extract data about our blood sugar levels from our insulin pumps or other self-monitoring devices. Because of this, these devices “are not being used to their full potential,” says Dr. Jenise Wong, the study’s principal investigator, in Science Daily. 3. Hypos Happen, Even in Hospitals. A recent audit of hospital stays by people with diabetes found that 30 percent of Type 1 patients admitted to hospitals experienced “a severe hypo within the last seven days.” (They define severe as a blood glucose level below 3.0 mmol/l.) D Continue reading >>

Diabetes Mellitus Type 1

Diabetes Mellitus Type 1

Diabetes mellitus type 1 (also known as type 1 diabetes) is a form of diabetes mellitus in which not enough insulin is produced.[4] This results in high blood sugar levels in the body.[1] The classical symptoms are frequent urination, increased thirst, increased hunger, and weight loss.[4] Additional symptoms may include blurry vision, feeling tired, and poor healing.[2] Symptoms typically develop over a short period of time.[1] The cause of type 1 diabetes is unknown.[4] However, it is believed to involve a combination of genetic and environmental factors.[1] Risk factors include having a family member with the condition.[5] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[2] Diabetes is diagnosed by testing the level of sugar or A1C in the blood.[5][7] Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies.[5] There is no known way to prevent type 1 diabetes.[4] Treatment with insulin is required for survival.[1] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[9] A diabetic diet and exercise are an important part of management.[2] Untreated, diabetes can cause many complications.[4] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[5] Long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[4] Furthermore, complications may arise from low blood sugar caused by excessive dosing of insulin.[5] Type 1 diabetes makes up an estimated 5–10% of all diabetes cases.[8] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[5] With Continue reading >>

Type 1 Diabetes May Cut Life Span, But Intensive Treatment Can Help Close The Gap

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 >>

Causes Of Death In Young Australians With Type 1 Diabetes: A Review Of Coronial Postmortem Examinations

Causes Of Death In Young Australians With Type 1 Diabetes: A Review Of Coronial Postmortem Examinations

Summary Objective: To determine the causes of death in Australians with type 1 diabetes mellitus who died aged 40 years or younger. Design and setting: Retrospective review of autopsy reports at the Department of Forensic Medicine, Sydney, New South Wales, 1 January 1994 – 31 December 2006. Main outcome measure: Causes of mortality in people with type 1 diabetes aged ≤ 40 years. Results: Of the 26 682 autopsy reports, 1914 were for individuals with diabetes (type 1, 400; type 2, 1514). Cardiovascular disease accounted for 51% of deaths (169/333) in people with type 1 diabetes aged > 40 years, versus 13% among those aged ≤ 40 years (9/67; P = 0.001). Acute complications of diabetes (27%; 18/67), unnatural deaths (28%; 19/67), and sudden unexpected deaths (22%; 15/67) were the predominant causes of death in young individuals with diabetes. Sudden unexpected death was more common in those with type 1 diabetes compared with a sex-matched control population in the same age range (22% v 5%; χ2 P < 0.001). Of the sudden unexpected deaths, 10 people were found dead in an undisturbed bed with no cause of death found at autopsy (“dead-in-bed” syndrome; mean age [SD], 30.2 [9.4] years; males : females = 4 :1). Conclusions: In deceased young people with type 1 diabetes examined by the Coroner, acute diabetic complications, unnatural causes, and sudden unexpected deaths were the predominant causes of death. The relatively high frequency of sudden unexpected deaths, such as dead-in-bed syndrome, requires further investigation. Continue reading >>

Time Trends In Mortality In Patients With Type 1 Diabetes: Nationwide Population Based Cohort Study

Time Trends In Mortality In Patients With Type 1 Diabetes: Nationwide Population Based Cohort Study

Abstract Objective To examine short and long term time trends in mortality among patients with early onset (age 0-14 years) and late onset (15-29 years) type 1 diabetes and causes of deaths over time. Design Population based nationwide cohort study. Setting Finland. Participants All Finnish patients diagnosed as having type 1 diabetes below age 30 years between 1970 and 1999 (n=17 306). Main outcome measures Crude mortality, standardised mortality ratios, time trends, and cumulative mortality. Results A total of 1338 deaths occurred during 370 733 person years of follow-up, giving an all cause mortality rate of 361/100 000 person years. The standardised mortality ratio was 3.6 in the early onset cohort and 2.8 in the late onset cohort. Women had higher standardised mortality ratios than did men in both cohorts (5.5 v 3.0 in the early onset cohort; 3.6 v 2.6 in the late onset cohort). The standardised mortality ratio at 20 years’ duration of diabetes in the early onset cohort decreased from 3.5 in the patients diagnosed in 1970-4 to 1.9 in those diagnosed in 1985-9. In contrast, the standardised mortality ratio in the late onset cohort increased from 1.4 in those diagnosed in 1970-4 to 2.9 in those diagnosed in 1985-9. Mortality due to chronic complications of diabetes decreased with time in the early onset cohort but not in the late onset cohort. Mortality due to alcohol related and drug related causes increased in the late onset cohort and accounted for 39% of the deaths during the first 20 years of diabetes. Accordingly, mortality due to acute diabetic complications increased significantly in the late onset cohort. Conclusion Survival of people with early onset type 1 diabetes has improved over time, whereas survival of people with late onset type 1 diabetes has det Continue reading >>

Natural History

Natural History

The pre-insulin era Childhood onset diabetes was rare – or at least, rarely diagnosed – in the pre-insulin era. Elliot Joslin collected such cases, despaired of by other physicians, and reported in 1917[1] that of 59 who developed diabetes before the age of 10, 38 had died within an average of 1.4 years. Their prognosis had however improved with a low carbohydrate ('Eskimo') diet. Death was from starvation, tuberculosis or diabetic coma. Lack of access to insulin in the world's poorest countries is still, in 2012, the commonest cause of death in a child with diabetes.[2] Joslin himself termed the period from 1898 to 1914 the Naunyn era, after the famous German physician, and the period from 1914 to 1922 the Allen era in honour of the undernutrition treatment which kept children alive, but at a terrible price. The period from 1922 to 1935 was named for Banting and Best, and the period after 1935 for Hagedorn, the Danish physician who introduced the first long-acting insulin. Each saw a steady prolongation of life for young patients on insulin. The prognosis on insulin Insulin was like a cure for cancer. Physicians such as Joslin soon learned that diabetic coma, previously fatal, could not only be treated with insulin with great success, but also prevented by appropriate education of families and their physicians. Tuberculosis became much less of a threat once children were properly nourished. Beyond this point, the future of children with diabetes was unknown. Joslin's 1935 medal pictured them as 'Explorers of Unknown Seas'. Sadly, it emerged in the 1930s that they were at risk of the delayed complications of diabetes: kidney disease, eye problems and premature heart disease. As a result, only one person in two who started insulin before the age of 20 would live to s Continue reading >>

Estimated Life Expectancy In A Scottish Cohort With Type 1 Diabetes, 2008-2010

Estimated Life Expectancy In A Scottish Cohort With Type 1 Diabetes, 2008-2010

Importance Type 1 diabetes has historically been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have occurred in the past 3 decades. Contemporary estimates of the effect of type 1 diabetes on life expectancy are needed. Objective To examine current life expectancy in people with and without type 1 diabetes in Scotland. We also examined whether any loss of life expectancy in patients with type 1 diabetes is confined to those who develop kidney disease. Design, Setting, and Participants Prospective cohort of all individuals alive in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24 691 contributing 67 712 person-years and 1043 deaths). Main Outcomes and Measures Differences in life expectancy between those with and those without type 1 diabetes and the percentage of the difference due to various causes. Results Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic hear Continue reading >>

Improvements In Life Expectancy In Type 1 Diabetes Patients In The Last Six Decades

Improvements In Life Expectancy In Type 1 Diabetes Patients In The Last Six Decades

Abstract To investigate the survival with diabetes in patients treated with insulin from diagnosis. Subjects and methods We analyzed 845 subjects, 55.9% males, registered at “I. Pavel” Bucharest Diabetes Centre, insulin-treated from diagnosis, aged <40 years and deceased between 1946 and 2005. We divided the subjects in two groups by age at diagnosis: group A <18 years and group B 18–39.99 years. We used 20 years time periods for year of death: 1946–1965, 1966–1985 and 1986–2005. The mean age at diabetes onset was 30.36 ± 8.04 years, disease duration at death 20.98 ± 11.62 years and age at death 51.34 ± 14.37 years. The mean increase in survival with diabetes was 19.3 years for group A and 15.9 years for group B. There was a significant decrease in infections in both groups. The increase in coronary heart diseases and stroke is evident only in group B. Conclusions We found no changes in age at onset, which combined with an increase in survival with diabetes lead to a significant increase in age at death over the six decades analyzed. Continue reading >>

Mortality Trends In Type 1 Diabetes

Mortality Trends In Type 1 Diabetes

The Allegheny County (Pennsylvania) Registry 1965–1999 Abstract OBJECTIVES—To investigate long-term mortality and its temporal trends as of 1 January 1999 among the 1,075 patients with type 1 diabetes (onset age <18 years, diagnosed between 1965 and 1979) who comprise the Allegheny County population-based registry. RESEARCH DESIGN AND METHODS—Overall, sex- and race-specific mortality rates per person-year of follow-up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (1965–1969, 1970–1974, and 1975–1979). RESULTS—Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 ± 5.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person-years (95% CI 532–728) and standardized mortality ratio was 519 (440–602). Life-analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 1965–1969 and that diagnosed during 1975–1979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes. CONCLUSIONS—An improvement in long-term survival was observed in the more recently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s. Continue reading >>

Diabetes Life Expectancy

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 >>

Mortality In Childhood-onset Type 1 Diabetes

Mortality In Childhood-onset Type 1 Diabetes

A population-based study Abstract OBJECTIVE—To describe the age- and sex-specific mortality in a cohort of young type 1 diabetic patients and to analyze the causes of death with special focus on suicide, accidents, and unexplained deaths. RESEARCH DESIGN AND METHODS—A population-based incident childhood diabetes register, covering onset cases since 1 July 1977, was linked to the Swedish Cause of Death Register up to 31 December 2000. The official Swedish population register was used to calculate age- and sex-standardized mortality rates (SMRs), excluding neonatal deaths. To analyze excess risks for specific diagnoses, case subjects were compared with five nondiabetic control subjects, matched by age, sex, and year of death. Death certificates were collected for all case and control subjects. For case subjects with an unclear diagnosis, hospital records and/or forensic autopsy reports were obtained. RESULTS—Mean age- and sex-SMR was 2.15 (95% CI 1.70–2.68) and tended to be higher among females (2.65 vs. 1.93, P = 0.045). Mean age at death was 15.2 years (range 1.2–27.3) and mean duration 8.2 years (0–20.7). Twenty-three deaths were clearly related to diabetes; 20 died of diabetic ketoacidosis. Only two case subjects died with late diabetes complications (acute coronary infarction). Thirty-three case subjects died with a diagnosis not directly related to diabetes; 7 of them committed suicide, and 14 died from accidents. There was no significant difference in traffic accidents (odds ratio 1.02 [95% CI 0.40–2.37]). Obvious suicide tended to be increased but not statistically significantly so (1.55 [0.54–3.89]). Seventeen diabetic case subjects were found deceased in bed without any cause of death found at forensic autopsy. Only two of the control subjects di Continue reading >>

3 Type 1 Diabetes

3 Type 1 Diabetes

Type 1 diabetes is an autoimmune disease in which the immune system destroys the insulin-producing beta cells of the pancreas. This results in a deficiency of insulin, causing chronic hyperglycemia. 3.1 PREVALENCE AND INCIDENCE A report from the SEARCH for Diabetes in Youth study, a national multicenter study sponsored by the CDC and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), found that between 2002 and 2005, 15,600 new cases of type 1 diabetes were diagnosed in the US37. The incidence and prevalence of type 1 diabetes are summarized in Tables 14-15. Table 14. Incidence of type 1 diabetes, United States youth. Source: Mayer-Davis et al. 200937 Table 15. Prevalence of type 1 diabetes, United States by age. Data Source Population Prevalence Reference SEARCH for Diabetes in Youth Age <20 years 0.148% (2001) Dabelea et al. 20141 0.193% (2009) NHANES 1999-2000 Age 20-39 years 0.34-0.42% Menke et al. 201338 Age 40-59 years 0.31-0.49% Age 60+ years 0.08-0.12% Type 1 diabetes incidence rates appear to be rising; assuming increases over time, the prevalence of type 1 diabetes may increase by as much as 144% by the year 2050 (Table 16). Table 16. Projected increases in type 1 diabetes prevalence among youth from 2010 to 2050. Source: Imperatore et al. 201239 Most recent studies place the prevalence of type 1 diabetes among US youth between 0.15% and 0.2%. Data from the SEARCH study indicated that the prevalence of type 1 diabetes among youth increased 21.1% between 2001 and 2009, with similar increases for boys and girls and in most racial/ethnic and age groups.1 The increase in prevalence in Scenario 2 was expected to occur especially among youths of minority race/ethnicity.39 3.2 DEMOGRAPHIC DIFFERENCES In the SEARCH for Diabetes in Youth Stud Continue reading >>

Mortality Rates For Type 1 Diabetes Patients Still Too High

Mortality Rates For Type 1 Diabetes Patients Still Too High

Despite major advances in the treatment of type 1 diabetes over the past 30 years, type 1 men are living approximately 11 fewer years than their non-diabetic peers. For women, the years lost is even higher at 13…. Scottish researchers examined data from a prospective cohort of patients in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24,691 contributing 67,712 person-years and 1,043 deaths). Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women). The researchers concluded that, “Estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy at age 20 years of approximately 11 years for men and 13 years for women compared w Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

About T1D Type 1 diabetes (T1D) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get energy from food. It occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, called beta cells. While its causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers are involved. Its onset has nothing to do with diet or lifestyle. There is nothing you can do to prevent T1D, and—at present—nothing you can do to get rid of it. Affects Children and Adults T1D strikes both children and adults at any age. It comes on suddenly, causes dependence on injected or pumped insulin for life, and carries the constant threat of devastating complications. Needs Constant Attention Living with T1D is a constant challenge. People with the disease must carefully balance insulin doses (either by injections multiple times a day or continuous infusion through a pump) with eating and daily activities throughout the day and night. They must also test their blood sugar by pricking their fingers for blood six or more times a day. Despite this constant attention, people with T1D still run the risk of dangerous high or low blood sugar levels, both of which can be life-threatening. People with T1D overcome these challenges on a daily basis. Not Cured By Insulin While insulin injections or infusion allow a person with T1D to stay alive, they do not cure the disease, nor do they necessarily prevent the possibility of the disease’s serious effects, which may include: kidney failure, blindness, nerve damage, amputations, heart attack, stroke, and pregnancy complications. Perseverance and Hope Although T1D is a serious and difficult disease, treatment Continue reading >>

The Dead In Bed Syndrome

The Dead In Bed Syndrome

Someone with type 1 diabetes is found dead in the morning in an undisturbed bed after having been observed in apparently good health the day before. No cause of death can be established. This is the typical situation of the "dead in bed" syndrome, a very tragic outcome which leaves the family with many unanswered questions: Why, when, how, could it have been avoided? After the first report from UK1 the observations have been confirmed from other countries.2,3 A number of young people with type 1 diabetes have been found dead in the morning without previous symptoms of illness, hyper- or hypoglycemia. The number of deaths of this kind per 10,000 patient years has been estimated to 2-6.4 For a population of 100,000 persons with diabetes, this represents 20-60 deaths per year or approximately 6% of all deaths in persons with diabetes aged less than 40 years.4 A relationship to human insulin1 or intensive insulin treatment2 has been postulated but does not seem likely.4 Autopsies have not revealed the cause of death. The diagnosis of hypoglycemia is difficult to confirm after death.5 There is however one case report where the person who died was wearing a retrospective (non-real-time) sensor, and the sensor reading demonstrated levels below 30 mg/dl (1.7 mmol/l) around the time of death (restrictions on reading glucose levels <40 mg/dl, 2.2 mmol/l, were removed by sensor manufacturer after the event), with at least 3 hours of severe hypoglycemia below <40 mg/dl, 2.2 mmol/l, before death.6 Another report using sensor tracings has shown a lag time of 2-4 hours before the onset of seizures when having severe hypoglycemia.7 In a recent review, clinical reports strongly suggest that nighttime hypoglycemia is a likely prerequisite of the event, but that the death is sudden and pr Continue reading >>

More in diabetes