Nav: Home

The Lancet Diabetes & Endocrinology: Older Americans with diabetes living longer without disability, US study shows

June 11, 2016

Older Americans with diabetes born in the 1940s are living longer and with less disability performing day to day tasks than those born 10 years earlier, according to new research published in The Lancet Diabetes & Endocrinology journal.

The study examined trends in disabled years of life among a national sample of US adults born in the 1940s compared with the 1930s. They found that adults with diabetes born in the 1940s generally become disabled later and were living more years without disability by the age of 70, than those born in the 1930s. The study did not differentiate between people with type 1 and type 2 diabetes.

"Over the past two decades, we have seen an increase in the length of good disability-free years of life in older Americans aged 50-70 both with and without diabetes", explains lead author Dr. Barbara Bardenheier from the US Centers for Disease Control & Prevention. "Our findings suggest that efforts to promote healthy lifestyles, advancements in the management of diabetes and other chronic conditions such as heart disease, and the increasing popularity of procedures such as hip and knee replacements have been successful in 'compressing disability' -- reducing the number of years with disability into later years, up to age 70." [1]

However, the authors warn that the trend seen among this older generation may not continue with an aging population more likely to develop type 2 diabetes and increased rates of obesity, unhealthy diets, alcohol, and physical inactivity meaning that diabetes is becoming more common. In the USA, the incidence and prevalence of type 2 diabetes has more than doubled over the last 20 years, and over 21 million Americans are now living with diabetes [2]. With the vast majority of cases of type 2 diabetes in adults over 65 being preventable, the authors say that efforts to prevent the onset of diabetes will continue to have the greatest impact on improving health.

Substantial reductions in mortality mean that people with diabetes are living longer [3] and, although yearly rates of several diabetes-related complications like heart attack, stroke, and amputations have fallen substantially over the last 20 years in the USA, it remains unclear whether these extra years of life with diabetes are lived with or without disability.

In this study, a team of US researchers analysed data on adults aged between 50 and 70 both with (1367) and without (11414) diabetes from the Health and Retirement Study, which surveys a nationally representative sample of more than 20000 older Americans every 2 years. They compared three types of disability including impaired mobility, less ability to perform activities of daily living such as bathing or eating, and impaired ability to carry out instrumental activities of daily living such as using the phone, shopping, and preparing meals, as well as recovery from disability, and death between two cohorts. Cohort 1 was born in the 1930s and followed 1992 to 2002, and cohort 2 was born in the 1940s and followed 2002 to 2012 (table 1). Modeling was used to estimate and compare the number of years lived with and without disability by age 70 in people with and without diabetes.

Gains in disability-free life years and compression of disability were seen in adults with and without diabetes and across the three types of disability. However, from age 50, adults living with diabetes in both cohorts had reduced life expectancy before age 70 and higher numbers of years living with disability compared to people without diabetes.

Adults living with diabetes who were born in the 1940s experienced a delay in all types of disability and a greater increase in disability-free years of life compared with adults living with diabetes born in the 1930s as well as living more years without disability prior to age 70. For example, a 50-year-old man living with diabetes born in the 1940s experienced a delay in the average age of disability onset for all three disability types (0.8 to 2.3 years later) compared with those born a decade earlier, while living 1.3 years longer and fewer years with a disability (0.4 to 1.0 fewer; table 3) prior to age 70. The findings were similar in women living with diabetes (table 4).

The authors note that their research was limited by a lack of data beyond age 70, restricting their analyses to fairly early disability, rather than more common age-related disability that occurs later in life. What's more, the model did not assess factors such as obesity, high blood pressure physical activity, education, and depression which could explain many of the differences seen between those with and without diabetes.

According to co-author Dr Edward Gregg at CDC, "We don't know whether this compression of disability in those with and without diabetes will continue. The chances of succumbing to type 2 diabetes are strongly connected to lifestyle. Smoking, an unhealthy diet, alcohol, and physical inactivity can all take their toll. Ultimately, prevention will play an important role in achieving more years of healthy life free of disability."[1]

Writing in a linked Comment, Dr Evelyn Wong from Deakin University, Melbourne, Australia says, "This study is important as it highlights the success and advancements in the management of chronic conditions in the postponement of disability...[However] future studies on the cost of this postponement of disability in light of the increasing prevalence of diabetes needs to be considered...As populations age and policies regarding retirement ages and eligibility for pensions become an increasingly important debate, future studies aimed at ascertaining compression or expansion of disability should focus on differences across social gradients. Programs to promote compression of disability may need to target the more socially disadvantaged groups specifically to decrease the health disparities across social stratum."

This study was funded by US Centers for Disease Control & Prevention

[1] Quotes direct from authors and cannot be found in text of Article.


[3] Among US diabetic adults, all-cause mortality fell 23% between 1997 and 2006.


The Lancet

Related Diabetes Articles:

The role of vitamin A in diabetes
There has been no known link between diabetes and vitamin A -- until now.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
Type 2 diabetes and obesity -- what do we really know?
Social and economic factors have led to a dramatic rise in type 2 diabetes and obesity around the world.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
The Lancet Diabetes & Endocrinology: Older Americans with diabetes living longer without disability, US study shows
Older Americans with diabetes born in the 1940s are living longer and with less disability performing day to day tasks than those born 10 years earlier, according to new research published in The Lancet Diabetes & Endocrinology journal.
Reverse your diabetes -- and you can stay diabetes-free long-term
A new study from Newcastle University, UK, has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes.
New cause of diabetes
Although insulin-producing cells are found in the endocrine tissue of the pancreas, a new mouse study suggests that abnormalities in the exocrine tissue could cause cell non-autonomous effects that promotes diabetes-like symptoms.
The Lancet Diabetes & Endocrinology: Reducing sugar content in sugar-sweetened drinks by 40 percent over 5 years could prevent 1.5 million cases of overweight and obesity in the UK and 300,000 cases of diabetes
A new study published in The Lancet Diabetes & Endocrinology journal suggests that reducing sugar content in sugar sweetened drinks (including fruit juices) in the UK by 40 percent over five years, without replacing them with any artificial sweeteners, could prevent 500,000 cases of overweight and 1 million cases of obesity, in turn preventing around 300,000 cases of type 2 diabetes, over two decades.
Breastfeeding lowers risk of type 2 diabetes following gestational diabetes
Women with gestational diabetes who consistently and continuously breastfeed from the time of giving birth are half as likely to develop type 2 diabetes within two years after delivery, according to a study from Kaiser Permanente published today in Annals of Internal Medicine.

Related Diabetes Reading:

Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me
by Adam Brown (Author), Kelly L. Close (Foreword)

Adam Brown’s acclaimed diaTribe column, Adam’s Corner, has brought life-transforming diabetes tips to over 1 million people since 2013. In this highly actionable guide, he shares the food, mindset, exercise, and sleep strategies that have had the biggest positive impact on his diabetes – and hopefully yours too! Bright Spots & Landmines is filled with hundreds of effective diabetes tips, questions, and shortcuts, including what to eat to minimize blood sugar swings; helpful strategies to feel less stressed, guilty, and burned out; and simple ways to improve exercise and... View Details

The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes
by Dr. Joel Fuhrman (Author)

The New York Times bestselling author of Eat to Live and Super Immunity and one of the country’s leading experts on preventive medicine offers a scientifically proven, practical program to prevent and reverse diabetes—without drugs.

At last, a breakthrough program to combat the rising diabetes epidemic and help millions of diabetics, as well as those suffering with high blood pressure and heart disease. Joel Fuhrman, M.D. Research director of the Nutritional Research Foundation, shows you how to live a long, healthy, and happy life—disease free. He... View Details

Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs
by Neal Barnard M.D. (Author)

Tackle diabetes and its complications for good with this newly updated edition of Dr. Neal Barnard's groundbreaking program.

Revised and updated, this latest edition of Dr. Barnard’s groundbreaking book features a new preface, updates to diagnostic and monitoring standards, recent research studies, and fresh success stories of people who have eliminated their diabetes by following this life-changing plan.

Before Dr. Barnard’s scientific breakthrough, most health professionals believed that once you developed diabetes, you were stuck with it―and could anticipate one... View Details

Diabetes For Dummies
by Alan L. Rubin (Author)

The straight facts on treating diabetes successfully

With diabetes now considered pandemic throughout the world, there have been enormous advances in the field. Now significantly revised and updated, this new edition of Diabetes For Dummies includes the latest information on diabetes medications and monitoring equipment, new findings about treating diabetes in the young and elderly, new ways to diagnose and treat long- and short-term complications, updated nutritional guidelines, new tools for measuring blood sugar and delivering insulin to the body, and much more.

There's... View Details

Choose Your Foods: Food Lists for Diabetes
by American Diabetes Association (Author)

The standard for diabetes meal planning for over 60 years, this edition features updated carbohydrate, protein, and fat information for a wide variety of foods and beverages and replaces exchange terminology with choices. Includes tips on exercise, reading food labels, and a glossary of diabetes related terms. View Details

The Official Pocket Guide to Diabetic Food Choices
by American Diabetes Association ADA (Author)

Completely updated to match the newest edition of Choose Your Foods: Food Lists for Diabetes Meal Planning, this pocket-sized guide is now better and more complete than ever.

Every day and at every meal, millions of people use the food list system to plan meals, make healthier choices, and better estimate portions. This proven system is the most popular approach to diabetes meal planning and has been used by dietitians, diabetes educators, and millions of people with diabetes for more than 70 years. This portable version of the Food Lists takes all of the information from... View Details

Diabetic Living Diabetes Meals by the Plate: 90 Low-Carb Meals to Mix & Match
by Diabetic Living Editors (Author)

An easy, graphic guide to planning delicious, diabetes-friendly meals This innovative, graphic cookbook offers the easiest and most flavorful way to build complete meals that are diabetes-friendly and delicious. Sidestepping complex programs that turn meal-planning into work, the 90 complete meals in Diabetes Meals by the Plate follow the Plate Method—a simple approach to eating the right foods in proper amounts by filling your plate with one half nonstarchy vegetables, one quarter protein, and one quarter starch. A clever photo style showing every meal in its three... View Details

Dr. Neal Barnard's Cookbook for Reversing Diabetes: 150 Recipes Scientifically Proven to Reverse Diabetes Without Drugs
by Neal Barnard M.D. (Author), Dreena Burton (Contributor)

150 delicious plant-based recipes designed to tackle diabetes and its complications.

Finally an approach to managing diabetes that is not based on pills or injections, but on food―the most delicious “prescription” you could imagine. Written by Dr. Neal Barnard, the unparalleled expert on diabetes and health, with recipes developed by Dreena Burton, bestselling cookbook author and creator of the Plant Powered Kitchen blog, this plant-based cookbook is filled with 150 easy and delicious recipes.

Inside, expect to find favorite foods like burgers, onion rings,... View Details

The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed (The Complete First Year)
by Gretchen Becker (Author), Allison B. Goldfine (Author)

The go-to step-by-step guide that walks you through the first days, weeks, and months of your diagnosis–fully revised and updated

Gretchen Becker was diagnosed with type 2 diabetes in 1996; over the past twenty years, she has educated herself on every aspect of the condition by reading medical texts and journals, talking with doctors, and corresponding with others who have type 2, sharing everything she's learned in a comprehensive, easy-to-use guide. Now in its third edition, The First Year: Type 2 Diabetes takes you through everything you need to learn and do in your... View Details

Taste of Home Diabetes Cookbook: Eat right, feel great with 370 family-friendly, crave-worthy dishes!
by Taste of Home (Editor)

Eat what you love and feel great with Taste of Home Diabetes Cookbook!

Looking to eat healthier?
Need to cut back on sugar and carbs?
Cooking for someone on a special diet?

With Taste of Home Diabetes Cookbook it’s a snap to serve mouthwatering sensations that everyone at the table will savor…whether they’re following a diabetic diet or not. Inside this all-new collection, you’ll find 370 mouthwatering dishes, each accompanied by a complete set of Nutrition Facts and Diabetic Exchanges. All of these must-try recipes were reviewed by a... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Consequences Of Racism
What does it mean to be judged before you walk through the door? What are the consequences? This week, TED speakers delve into the ways racism impacts our lives, from education, to health, to safety. Guests include poet and writer Clint Smith, writer and activist Miriam Zoila Pérez, educator Dena Simmons, and former prosecutor Adam Foss.
Now Playing: Science for the People

#465 How The Nose Knows
We've all got a nose but how does it work? Why do we like some smells and not others, and why can we all agree that some smells are good and some smells are bad, while others are dependant on personal or cultural preferences? We speak with Asifa Majid, Professor of Language, Communication and Cultural Cognition at Radboud University, about the intersection of culture, language, and smell. And we level up on our olfactory neuroscience with University of Pennsylvania Professor Jay Gottfried.