Back in the day, before insulin was discovered, diabetes type 1 was considered a fatal disease. Based on current research studies, various studies would give different numbers regarding by how many years the lifespan is decreased due to diabetes type 1 and type 2. Some calculators are available online where one person can check the life expectancy for those with diabetes with or without associated conditions. However, there are serious limitations to these calculators.
More importantly than numbers and statistics is to really understand why and how diabetes can affect longevity and the huge difference in outcomes between well-managed and poorly managed diabetes.
Why diabetes may affect the lifespan
Higher risk for heart complications. The top reason why individuals with diabetes die earlier is cardiovascular conditions. High sugar levels in the blood are toxic to bodily’s tissues and damage blood vessels and the nerves that control the heart. Furthermore, those with diabetes may also have hypertension, high cholesterol levels, excess weight (in case of diabetes type 2), and kidney diseases which increase the risk of heart diseases and lead to decreased lifespan. Diabetes ketoacidosis is a potentially life-threatening complication more commonly associated with diabetes type 1.
- Hypertension. The majority of individuals with diabetes type 2 also have higher than normal blood pressure. Both diabetes and hypertension increase the risk of heart diseases, strokes and kidney diseases, conditions linked with decreased lifespan.
- Kidney complications. Over 40% of causes of kidney failure occur in individuals with diabetes. Kidney failure increases the risk for heart diseases and may reduce life expectancy.
- Diabetic neuropathy is another common complication of diabetes, as long term uncontrolled sugar levels are damaging the nerves. When this neuropathy affects nerves in the feet, people lose sensation, having increased risk for injuries, trauma and some may require amputation. Diabetic neuropathy also affects the nerves of the autonomic nervous system, which control the function of the heart and other major organs. This neuropathy increases the risk of not feeling chest pain when having a heart attack and not seeking medical attention.
- Smoking and/or alcohol abuse. According to the Centers of Disease Control and Prevention (CDC), the life expectancy for smokers is at least 10 years shorter than for nonsmokers. Individuals who have diabetes and also smoke are at much higher risks to have an even shorter life.
Well-controlled vs poorly controlled diabetes and other associated conditions
One research study gives us an idea about how important it is to keep diabetes and other associated medical conditions under control. Scientists found that 5 years after the diagnosis, individuals who receive the diagnosis of diabetes at age 55 with risk factors – smokers, have hypertension (systolic blood pressure of 180 mmHg), unhealthy cholesterol levels (total: HDL cholesterol ratio= 8), and diabetes poorly controlled ( HbA1c of 10%), may live 8 years less compared with individuals who have diabetes under control (HbA1c of 6%), healthy blood pressure (systolic blood pressure 120 mmHg) and healthy cholesterol levels (total/HDL ratio of 4).
Did you know an anti-diabetes drug may boost longevity?
Researchers evaluated hundreds of different drugs for their anti-aging potentials and ability to boost longevity. Metformin, the most common drug prescribed for type 2 diabetes is on top of the list and has been extensively researched for reversal of physiology and biology of aging, and there are over 100 clinical studies in progress. In animal models, metformin was already found to extend the lifespan and healthspan. Metformin acts as an antiaging drug through several important pathways: it mimics the effects of caloric restriction, decreases IGF-1 signaling (essential for longevity in all mammals), activates SIRT1, activates AMP-kinase, and inhibits mTOR. Beyond improving blood glucose levels, metformin reduces oxidative stress, and inflammation, decreasing the risk of cardiovascular diseases and cancers and preventing early death.
Millions of people all around the world live with diabetes. When it comes to how diabetes affects the lifespan, remember it is more important to focus on the blood sugar levels and keeping them well under control. This means both random sugar checks and keeping hemoglobin A1c (HbA1c) within healthy limits, the latter showing how well diabetes has been controlled over the last few months. Keeping diabetes under control reduces the risk of complications. And if complications occur, they should also be treated properly. Any associated conditions like high blood pressure, high cholesterol levels, diabetic neuropathy, or kidney diseases should also be kept under control. Many people can achieve diabetes control with lifestyle changes and medication. There are plenty of dietary plans that can help manage diabetes- from the Mediterranean diet to a low glycemic diet and low carbohydrate diets. Exercise has a strong impact on insulin sensitivity and along with diet, will promote healthy weight. Getting a good night’s sleep and managing stress are additional lifestyle strategies that help maintain healthy blood sugar levels. Some supplements can also help.