Ideal type 2 diabetes management leads to years of life gained

A person trying to manage their type 2 diabetes might understand in the abstract the impact of the disease on their health. A doctor, for example, might tell them they are two to four times more likely to die of heart disease.

Telling a patient, however, that well managed blood glucose, could add nearly four years to their life — or conversely, that failing to control it will cut life short by four years — packs an emotional punch in its specificity.

A modelling study by University of Florida Health researchers estimates the years that might be added to the lifespan of someone with type 2 diabetes with improved management of the disease. The findings, they hope, might motivate patients to follow a healthier lifestyle.

The study focused on measures commonly used to monitor patients with diabetes:

  • blood pressure
  • low-density lipoprotein, or LDL, cholesterol, also known as “bad” cholesterol
  • haemoglobin A1c, HbA1c
  • body mass index.

“Better control of biomarkers can potentially increase the life expectancy by three years in an average person with type 2 diabetes in the U.S.,” the study said. “For individuals with very high levels of HbA1c, systolic blood pressure, LDL cholesterol and BMI, controlling biomarkers can potentially increase life expectancy by more than 10 years ,” said study co-author Hui Shao, M.D., Ph.D.

But people with diabetes can extend their life span even if they don’t hit their optimal treatment goals, Shao said.

“The hope is to show people with type 2 diabetes in an easily understood way the benefits of controlling their disease.”

The findings were generated by a microsimulation that is optimised using data from a clinical trial involving patients with type 2 diabetes at increased risk of cardiovascular disease.

Findings show life expectancy is increased by either:

  • 1.9, 1.5 or 1.1 years when systolic blood pressure is improved from a high of 160.4 mmHg to 114.1, 128.2 or 139.1 mmHg, respectively.
  • 0.9, 0.7 or 0.5 years when LDL cholesterol is improved from a high of 146.2 mg/dL to 59, 84 or 107 md/dL, respectively.
  • 3.8, 3.4 or 0.5 years when HbA1c is improved from a high of 9.9% to 5.9%, 7.7% or 6.8%, respectively.
  • 3.9, 2.9 or 2 years when BMI is improved from a high of 41.4 to 24.3, 28.6 or 33.

Even longer life expectancy is possible when the impact of improving multiple biomarkers is combined, hence the finding that someone can bank an extra decade by vastly improving all measures. Shao noted BMI is the most important measure, since losing weight can have a positive effect on the others.

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