Diabetes: Complications

Type 1 Diabetes May Cut Life Span, but Intensive Treatment Can Help Close the Gap

Written by Sandra Levy | Published on January 6, 2015

Type 1 Diabetes May Cut Life Span, but Intensive Treatment Can Help Close the Gap

(People with type 1 diabetes may have a shorter life expectancy than their peers, but intensive treatment may help offset that risk, say two separate new studies.

In the first study, published in JAMA, Shona J. Livingstone of the University of Dundee in Scotland and her colleagues compared the life expectancy of Scottish men and women ages 20 and older who had type 1 diabetes to a group of adults without the condition.

Life expectancy after age 20 was an additional 46.2 years among men with type 1 diabetes, but 57.3 years among men without the condition, an estimated loss of 11.1 years.

The life expectancy after age 20 for women with type 1 diabetes was an additional 48.1 years, compared to 61 years among women without it, an estimated loss of 12.9 years for women with diabetes.

In the general population without type 1 diabetes, 76 percent of men and 83 percent of women lived to age 70, compared with 47 percent of men and 55 percent of women with type 1 diabetes.

In a separate study, also published in JAMA, Dr. Trevor J. Orchard, a professor of epidemiology, medicine, and pediatrics at the University of Pittsburgh, looked at whether mortality differed between patients getting intensive vs. conventional therapy in the long-term follow-up of the Diabetes Control and Complications Trial (DCCT).

After an average of 27 years of follow-up for patients with type 1 diabetes, 6.5 years of initial intensive diabetes therapy was associated with a modestly lower rate of death from all causes, compared to conventional therapy.)

Diabetes – A Major Risk Factor For Kidney Disease

www.kidney.org

Diabetes – A Major Risk Factor For Kidney Disease

(About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure.)

Complications/Co-Morbid Conditions

http://www.diabetes.org/

  • Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis.
  • Hypertension: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 71% had blood pressure greater than or equal to 140/90 millimeters of mercury or used prescription medications to lower high blood pressure.
  • Dyslipidemia: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 65% had blood LDL cholesterol greater than or equal to 100 mg/dl or used cholesterol-lowering medications.
  • CVD Death Rates: In 2003–2006, after adjusting for population age differences, cardiovascular disease death rates were about 1.7 times higher among adults aged 18 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Heart Attack Rates: In 2010, after adjusting for population age differences, hospitalization rates for heart attack were 1.8 times higher among adults aged 20 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Stroke: In 2010, after adjusting for population age differences, hospitalization rates for stroke were 1.5 times higher among adults with diagnosed diabetes aged 20 years or older compared to those without diagnosed diabetes.
  • Blindness and Eye Problems: In 2005–2008, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) people had diabetic retinopathy, damage to the small blood vessels in the retina that may result in loss of vision.
  • Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011.
    • In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.
    • In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
  • Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.
    • About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes.

– See more at: http://www.diabetes.org/diabetes-basics/statistics/?referrer=http://seekingalpha.com/article/4002856-mannkind-curtain-drawn-microphone-place?page=2#sthash.GRyPU8Bd.dpuf

Complications

By Mayo Clinic Staff at mayoclinic.org

Type 1 diabetes can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys. Keeping your blood sugar level close to normal most of the time can dramatically reduce the risk of many complications.

Long-term complications of type 1 diabetes develop gradually, over decades. Good blood sugar management can help lower the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.

Heart and blood vessel disease. Diabetes dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.

Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar could cause you to eventually lose all sense of feeling in the affected limbs.

Damage to the nerves that affect the gastrointestinal tract can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue.

Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which requires dialysis or a kidney transplant.

Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which often heal poorly and may ultimately require toe, foot or leg amputation.
Skin and mouth conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.

Pregnancy complications. High blood sugar levels can be dangerous for both the mother and the baby. The risk of miscarriage, stillbirth and birth defects are increased when diabetes isn’t well-controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia.

Complications/Co-Morbid Conditions

diabetes.org

  • Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis.
  • Hypertension: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 71% had blood pressure greater than or equal to 140/90 millimeters of mercury or used prescription medications to lower high blood pressure.
  • Dyslipidemia: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 65% had blood LDL cholesterol greater than or equal to 100 mg/dl or used cholesterol-lowering medications.
  • CVD Death Rates: In 2003–2006, after adjusting for population age differences, cardiovascular disease death rates were about 1.7 times higher among adults aged 18 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Heart Attack Rates: In 2010, after adjusting for population age differences, hospitalization rates for heart attack were 1.8 times higher among adults aged 20 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
  • Stroke: In 2010, after adjusting for population age differences, hospitalization rates for stroke were 1.5 times higher among adults with diagnosed diabetes aged 20 years or older compared to those without diagnosed diabetes.
  • Blindness and Eye Problems: In 2005–2008, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) people had diabetic retinopathy, damage to the small blood vessels in the retina that may result in loss of vision.
  • Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011.
    • In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.
    • In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
  • Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.
    • About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes.

CDC: 52% With Diabetes Have Arthritis

Per this article, more than half of people with diabetes also suffer arthritis, CDC researchers find. It’s not just a problem for older people. Diabetes patients aged 18 to 44 have a 27.6% chance of having arthritis — 2.5 times the 11% rate seen in the general population. In the 45-64 age group, arthritis strikes 51.8% of people with diabetes and 36.4% of the general population. Arthritis afflicts 62.4% of diabetes patients 65 and older, vs. 56.2% of those without diabetes. The findings come from nationwide telephone surveys conducted in 2005 and 2007. The extent of the problem surprised the research team, says Charles Helmick, MD, lead scientist for the CDC’s arthritis program.
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