Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010

Shona J Livingstone, Daniel Levin, Helen C Looker, Robert S Lindsay, Sarah H Wild, Nicola Joss, Graham Leese, Peter Leslie, Rory J McCrimmon, Wendy Metcalfe, John A McKnight, Andrew D Morris, Donald W M Pearson, John R Petrie, Sam Philip, Naveed A Sattar, Jamie P Traynor, Helen M Colhoun, Scottish Diabetes Research Network (SDRN) Epidemiology group

Research output: Contribution to journalArticle

196 Citations (Scopus)

Abstract

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 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).

CONCLUSIONS AND RELEVANCE: 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 with the general population without type 1 diabetes.

Original languageEnglish
Pages (from-to)37-44
Number of pages8
JournalJAMA
Volume313
Issue number1
DOIs
Publication statusPublished - 6 Jan 2015

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Life Expectancy
Type 1 Diabetes Mellitus
Scotland
Diabetic Coma
Diabetic Ketoacidosis
Kidney Diseases
Glomerular Filtration Rate
Myocardial Ischemia

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Diabetes Mellitus, Type 1
  • Diabetic Coma
  • Female
  • Humans
  • Life Expectancy
  • Male
  • Middle Aged
  • Myocardial Ischemia
  • Prospective Studies
  • Scotland
  • Sex Factors
  • Young Adult

Cite this

Livingstone, S. J., Levin, D., Looker, H. C., Lindsay, R. S., Wild, S. H., Joss, N., ... Scottish Diabetes Research Network (SDRN) Epidemiology group (2015). Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. JAMA, 313(1), 37-44. https://doi.org/10.1001/jama.2014.16425

Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. / Livingstone, Shona J; Levin, Daniel; Looker, Helen C; Lindsay, Robert S; Wild, Sarah H; Joss, Nicola; Leese, Graham; Leslie, Peter; McCrimmon, Rory J; Metcalfe, Wendy; McKnight, John A; Morris, Andrew D; Pearson, Donald W M; Petrie, John R; Philip, Sam; Sattar, Naveed A; Traynor, Jamie P; Colhoun, Helen M; Scottish Diabetes Research Network (SDRN) Epidemiology group.

In: JAMA, Vol. 313, No. 1, 06.01.2015, p. 37-44.

Research output: Contribution to journalArticle

Livingstone, SJ, Levin, D, Looker, HC, Lindsay, RS, Wild, SH, Joss, N, Leese, G, Leslie, P, McCrimmon, RJ, Metcalfe, W, McKnight, JA, Morris, AD, Pearson, DWM, Petrie, JR, Philip, S, Sattar, NA, Traynor, JP, Colhoun, HM & Scottish Diabetes Research Network (SDRN) Epidemiology group 2015, 'Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010', JAMA, vol. 313, no. 1, pp. 37-44. https://doi.org/10.1001/jama.2014.16425
Livingstone SJ, Levin D, Looker HC, Lindsay RS, Wild SH, Joss N et al. Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. JAMA. 2015 Jan 6;313(1):37-44. https://doi.org/10.1001/jama.2014.16425
Livingstone, Shona J ; Levin, Daniel ; Looker, Helen C ; Lindsay, Robert S ; Wild, Sarah H ; Joss, Nicola ; Leese, Graham ; Leslie, Peter ; McCrimmon, Rory J ; Metcalfe, Wendy ; McKnight, John A ; Morris, Andrew D ; Pearson, Donald W M ; Petrie, John R ; Philip, Sam ; Sattar, Naveed A ; Traynor, Jamie P ; Colhoun, Helen M ; Scottish Diabetes Research Network (SDRN) Epidemiology group. / Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. In: JAMA. 2015 ; Vol. 313, No. 1. pp. 37-44.
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abstract = "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 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).CONCLUSIONS AND RELEVANCE: 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 with the general population without type 1 diabetes.",
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T1 - Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010

AU - Livingstone, Shona J

AU - Levin, Daniel

AU - Looker, Helen C

AU - Lindsay, Robert S

AU - Wild, Sarah H

AU - Joss, Nicola

AU - Leese, Graham

AU - Leslie, Peter

AU - McCrimmon, Rory J

AU - Metcalfe, Wendy

AU - McKnight, John A

AU - Morris, Andrew D

AU - Pearson, Donald W M

AU - Petrie, John R

AU - Philip, Sam

AU - Sattar, Naveed A

AU - Traynor, Jamie P

AU - Colhoun, Helen M

AU - Scottish Diabetes Research Network (SDRN) Epidemiology group

PY - 2015/1/6

Y1 - 2015/1/6

N2 - 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 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).CONCLUSIONS AND RELEVANCE: 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 with the general population without type 1 diabetes.

AB - 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 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).CONCLUSIONS AND RELEVANCE: 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 with the general population without type 1 diabetes.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cause of Death

KW - Diabetes Mellitus, Type 1

KW - Diabetic Coma

KW - Female

KW - Humans

KW - Life Expectancy

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia

KW - Prospective Studies

KW - Scotland

KW - Sex Factors

KW - Young Adult

U2 - 10.1001/jama.2014.16425

DO - 10.1001/jama.2014.16425

M3 - Article

C2 - 25562264

VL - 313

SP - 37

EP - 44

JO - JAMA

JF - JAMA

SN - 0098-7484

IS - 1

ER -