Type 2 diabetes reduces life expectancy of women, younger people and smokers, data finds

Type 2 diabetes takes a greater toll on the mortality and life expectancy of women, younger people and smokers, according to new research being presented at the annual meeting of the European Association for the Study of Diabetes.

The data shows that a woman with type 2 diabetes has 60 per cent increased chance of an early death and will live five years less than the average woman in the general population.

Meanwhile, men with type 2 diabetes have a 44 per cent increased risk of dying prematurely and live 4.5 years less, the modelling by Mike Stedman, of Res Consortium, a healthcare consultancy in Andover, UK, Dr Adrian Heald, of Salford Royal Hospital, Salford, UK and colleagues, indicates.

Smoking shortens the life expectancy of people with the condition by ten years, while diagnosis at an earlier age (before the age of 65) reduces life expectancy by over eight years.

More than three million people in the UK have been diagnosed with type 2 diabetes, the most common form of the condition with numbers expected to rise in future years. It usually occurs in middle-aged and older people but onset at a younger age is becoming more common globally.

People in England with diabetes are known to have a 50 to 70 per cent higher risk of dying prematurely than individuals without diabetes (this is known as the age-standardised mortality ratio or SMR).

The researchers worked out the life expectancy of 11, 806 people with type 2 diabetes over a ten-year period and compared this to life expectancy figures for the general population.

They then looked at the effect of demographic and lifestyle factors on mortality rate and life expectancy of the individuals with the condition.

The data used included the participants’ health records from 2010 to 2020 (stopping before the COVID-19 pandemic), information from the Office for National Statistics on life expectancy of the general population and information from the Index of Multiple Deprivation.

A total of 3,921 of the participants died during the ten years studied, compared to an expected 2,135, giving a standardised mortality ratio (SMR) of 1.84, meaning that the risk of an early death was 84 per cent higher in people with diabetes than in the general population.

The increased risk of early death was 22 per cent greater for women with type 2 diabetes than for men with the condition.

This surprised the researchers because type 2 diabetes is generally assumed to have a greater effect on men’s health than on women’s.

When the results were adjusted to take into account levels of deprivation, those with type 2 diabetes still had a significantly higher risk of an early death.

With adjustment for deprivation, a woman with type 2 diabetes was 60 per cent more likely to die early than someone in the general population, while a man with the condition was 44 per cent more likely to die prematurely.

The results also suggest that type 2 diabetes has a greater effect on the life expectancy of people diagnosed at a younger age. Those diagnosed below 65 years old had a 93 per cent higher risk of an early death and lived more than eight years less than people of the same age in the general population. Those diagnosed at 65 and older lost less than two years.

Smoking had the largest effect on the mortality and life expectancy of people with type 2 diabetes. The modelling found that people with the condition who smoked were 2.5 times more likely to die prematurely than people in the general population.

Smokers with type 2 diabetes lived ten years less than people in the general population; non-smokers and ex-smokers with the condition lost three years of life expectancy.

The modelling found that a female smoker who was diagnosed before the age of 65 was 3.75 times more likely to die prematurely and lived 15 years less than a woman in the general population of the same age.

Dr Heald said: “Our modelling suggests that type 2 diabetes has a greater effect on the life expectancy of women, smokers and those diagnosed at a younger age.

“A woman with type 2 diabetes for example, might live five years less than the average woman in the general population, while someone diagnosed at a younger age might lose eight years of life expectancy.”

Dr Heald added: “It is vital that the groups at the highest risk are made aware of not just the increased risk that they face but also the size of the risk.

“Doing so may make the health advice they are given seem more relevant and so help them make changes that can improve their quality – and length – of life.”

Dr Lucy Chambers, Head of Research Communications at Diabetes UK, said: “This research is a stark reminder of the seriousness of type 2 diabetes, laying bare the devastating impact the condition can have on life expectancy.

“Importantly, the findings highlight that the impact of type 2 diabetes is not the same for everyone, suggesting that women, people who smoke, those diagnosed under 65 years, and people living in deprived areas have a lower life expectancy than others with the condition.”

She concluded: “Research like this is crucial in understanding more about which groups of people with type 2 diabetes could benefit from tailored care to reduce their heightened risk of complications and could in future help to close unacceptable gaps in health and life expectancy.

“While research like this can be alarming, it’s important to remember that with the right support, many cases of type 2 diabetes and its complications can be prevented or delayed, and that many people with the condition can live long and healthy lives.”

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