Here is an interesting exercise for those of you approaching or past middle age. Take out a tape measure, put it on the floor and pull it out to 81 inches: 81 years is about the average life expectancy of a person living in Canada. Stand on the tape at the number corresponding to your age. Look to the left (the number of years you’ve lived) and then look to the right (the amount of time you have left). This is a bit of a sobering experience!
In 2017, the life expectancy for the total Canadian population is projected to be 79 years for men and 83 years for women. The life expectancy of Métis and First Nations populations is lower – 73 to 74 years for men and 78 to 80 years for women.
The bad news
People with diabetes have been told they have a shortened life expectancy due to their disease and this is true. Because diabetes is more common in Métis and First Nations populations, the already shortened life expectancy is of even greater concern. The number of years shortened depends on the age at which you get diabetes and how you look after yourself.
The good news
Lifestyle choices or health behaviours, as they are called now, can make a significant difference to this shortened expectation for all of us, but even more so for a person living with diabetes. The other good news is that complication rates per person with diabetes – such as kidney disease, amputations, heart attacks, strokes and death from heart attacks – are going down. How you take care of yourself greatly changes your life expectancy.
Those with well-controlled sugars and no kidney complications have a much longer life span than those with higher sugars and protein in their urine. So, preventing kidney disease is important in maintaining longevity. Interestingly, in a Swedish database, people with diabetes who were 65 year of age or older, had an A1C less than 7.8% and no protein in their urine had a lower risk of dying than people without diabetes. This was thought to be because they were taking heart-protective medications such as cholesterol-lowering and blood pressure pills.
The United Kingdom Prospective Diabetes Study Outcomes Model is a computer program that predicts the likelihood of serious diabetes-related complications, and death, in people living with type 2 diabetes. For example, if you are a 55-year-old man who has been living with type 2 diabetes for the past five years, your life expectancy is predicted to be as follows:
- 13.2 years for someone who:
- Has a systolic blood pressure of 180 mmHg
- Has a total/high-density lipoprotein cholesterol ratio of 8
- Has an A1C of 10%
- Compare this to 21.1 years for 1someone who:
- Is a non-smoker
- Has a systolic blood pressure of 120 mmHg
- Has a total/high-density lipoprotein cholesterol ratio of 4
- Has an A1C of 6%
The effect of diabetes on life expectancy also depends on how old you are when you are diagnosed with the disease. The younger you are, the longer you will live with the disease and the more likely it will shorten your life expectancy.
So, if you are at risk for diabetes because you have risk factors, such as having a family history of type 2 diabetes or coming from a high-risk population (e.g. South Asian, Indigenous), or if you have prediabetes, it makes sense to delay the onset of diabetes by reducing the risk factors under your control. This can be done by adopting health behaviours such as eating well, attaining your ideal weight, not smoking and getting regular exercise. In some case of prediabetes, your doctor may suggest medication (metformin) to delay the onset of diabetes.
So, good news or bad news? It’s up to you!