AGEING WELL WITH DIABETES

It’s well known that on average, people with diabetes do not live as long as people without the condition, due to increased risk of cardiovascular diseases (e.g., heart attack and stroke; peripheral artery disease), kidney disease, neuropathy, digestive diseases, etc… How significant is the problem and what can be done about it?

Average life expectancy for people with diabetes

A new systematic review and meta-analysis investigated average life expectancy in women and men living with and without diabetes. It included 23 studies incorporating 179 cohorts from Africa, America, Asia, Europe and Oceania with 65 thousand individuals with Type 1 Diabetes (T1D), over 139 million with Type 2 Diabetes (T2D) and over 1,563 million people without diabetes.

• Women without diabetes average life expectancy was 84.46 years and men was 79.56 years.
• For individuals with T1D, average life expectancy was 68.26 years in women and 65.12 years in men.
• For individuals with T2D, average life expectancy was 79.63 years in women and 74.34 years in men.

Among individuals with type 2 diabetes, average life expectancy varied by region, with those living in Asia and Europe living the longest for both sexes. Unfortunately, there were not enough studies in people with type 1 diabetes to do an analysis by region.

Life expectancy is increasing for individuals with diabetes

Another recent systematic review of 35 studies from 17 countries/regions (predominantly Europeans) reported on long-term mortality trends in people with diabetes (predominantly T2D).

The populations studied had decreasing trends in all-cause mortality (death) rates in people with diabetes:

• Between 1970–1989, a 43% decline,
• 1990–1999, a 53% decline,
• 2000–2016, a 74% decline.

Studies specific to people with T1D also show significant decreases in age-standardised death rates from 53.16 to 47.11 per 100,000 people, with an estimated average annual percentage change of −0.48%, or around -15% in total, from 1990 to 2021.

Significant improvements in pharmacological management, blood glucose monitoring technologies and lifestyle management have all occurred over the past 5 decades, helping people with diabetes live longer.

Can you increase your life expectancy if you have diabetes?

A recent study in the United States, using data from 421 people, found that improving comprehensive diabetes management (i.e., decreasing weight, blood glucose, blood pressure and cholesterol), can significantly increase life expectancy in people with type 2 diabetes by around 10 years.

Weight: Reducing average Body Mass Index (BMI) by 17 kg / m2, from 41.4 kg / m2 to 24.3 kg / m2, increased life expectancy by 3.9 years.

Blood glucose: Reducing glycated haemoglobin (HbA1c), the 3-month average of blood glucose, by 2.2% points, from 9.9% to 7.7%, increased life expectancy by 3.4 years and a further reduction to 6.8% was associated with an additional ½ year increase in life expectancy.

Blood cholesterol: Lowering LDL (“bad”) cholesterol by 2.3 mmol/L (88 mg/dL), from 3.8 mmol/L (146 mg/dL) to 1.5 mmol/L (59 mg/dL), was associated with an increased life expectancy of 0.9 years.

Blood pressure: Lowering systolic blood pressure by 46.3 mm Hg, from 160.4 mm Hg to 114.1 mm Hg was associated with an increased life expectancy of 1.9 years.

Therefore, managing diabetes as well as possible by being physically active, eating well, monitoring blood glucose/pressure/cholesterol and taking medication (when appropriate) can significantly increase life expectancy back to levels experienced by people without diabetes.

Read more:

• Ezzatvar and colleagues. Life expectancy in individuals with type 1, type 2 diabetes and without diabetes: a systematic review and meta-analysis. Front. Endocrinol, 2025.
• Chen and colleagues. A systematic review of trends in all-cause mortality among people with diabetes. Diabetologia. 2020.
• Liu and colleagues. Global burden of type 1 diabetes mellitus in women of childbearing age from 1990 to 2021 with projections to 2030. Medicine,2025.
• Kianmehr and colleagues. Potential Gains in Life Expectancy Associated With Achieving Treatment Goals in US Adults With Type 2 Diabetes. JAMA Netw Open. 2022..