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New research organized by the University of Cambridge in Britain suggests that having diabetes at 50 may reduce a person's life expectancy by an average of six years. The large international study to measure diabetes' toll found the disease also raises the risk of dying prematurely from other serious ailments, including heart disease, breast cancer and pneumonia.
The research, funded by the Medical Research Council (MRC), underlines the importance of preventing diabetes, which affects more than 285 million people worldwide. Scientists from the Emerging Risk Factors Collaboration -- a group led by Professor John Danesh, head of the Department of Public Health and Primary Care -- analyzed data on more than 820,000 people, each of whom was monitored for about a decade. Even after researchers accounted for other major risk factors such as age, sex, obesity and smoking, they found that people with diabetes are at increased risk of death from several common cancers, infections, mental health disorders, and liver, kidney and lung diseases. "It's quite a wide sweep of conditions," Danesh told the Associated Press (AP). While most people think of heart problems, diabetes surprisingly "appears to be associated with a much broader range of health implications than previously suspected," he added.
Diabetes is the seventh leading cause of death in the United States, affecting nearly 26 million Americans, including 7 million who have gone undiagnosed. Most of the study participants were thought to have the most common kind of diabetes -- Type 2 -- which occurs when the body makes too little insulin or cannot use what it does make to regulate blood sugar. The new research did not include those who had heart disease when they were first enrolled. Participants were followed for an average of 13.5 years, and during the studies, there were more than 123,000 deaths. Overall, death rates from various causes were higher for those with diabetes than those without. About 60 percent of reduced life expectancy in people with diabetes is attributable to blood vessel diseases, such as heart attack and stroke. The remaining 40 percent is attributable to other conditions.
The researchers found that diabetics had a 25 percent greater risk of dying from cancer and were more likely to die from a variety of other illnesses than from heart attack and stroke. Exactly how diabetes raises those risks is not clear, but in the case of infections, it could be that the immune system is weakened in people with diabetes, according to researchers. Diabetes can cause vision problems and loss of feeling in the lower extremities, which can lead to falling, which is also among the leading causes of death in people with diabetes. One intriguing finding, said Danesh, was a higher risk of suicide in people with diabetes. Other research has linked diabetes with depression, he noted. Dr. Alvin Powers, a diabetes specialist at Vanderbilt University, told AP's Stephanie Nano that the findings show a good "reason to try to normalize blood glucose in people who have diabetes" through diet, medication and exercise. "There have been smaller studies that hinted at this but nothing where a study of this size looked at so many different outcomes." Danesh and colleagues calculated that a 50-year-old diabetic without heart disease dies about six years sooner than someone without diabetes, with 40 percent of the difference due to cancer and conditions other than heart disease. "It underscores the need to prevent diabetes," he said. The new paper showed a link between some cancers, but not all, and diabetes. The increased risk ranged from 25 percent for breast cancer to 50 percent for liver cancer. Danesh said that people with diabetes should get age-appropriate cancer screenings. Dr. Richard Bergenstal of the International Diabetes Center at Park Nicollet in Minneapolis, one of the authors on the paper, said the new research shows that there is "a lot more we need to understand about diabetes and the link to cancer." While adding to the evidence, the study doesn't answer questions of why, he said. "Diabetes is a serious condition. We often don't quite think about it quite that way." The collaborative study involved over 250 scientists from 25 countries and was based on nearly 100 studies from Europe and North America. The study, which was funded by the MRC, British Heart Foundation and Pfizer, is published in Thursday's New England Journal of Medicine.
