When you’re diagnosed with diabetes, you may wonder, “Is this going to kill me? How long can I live with this?” These are scary questions. Fortunately, the answers have gotten better.
History of life with type 1
In type 1, the insulin-producing beta cells in the pancreas are destroyed. Before insulin was discovered and made injectable, people with type 1 diabetes generally wouldn’t survive more than a few months. The only treatment known to medicine was going on a low-carb, high-fat and -protein diet. People might live a few years that way.
According to the website Defeat Diabetes, “In 1897, the average life expectancy for a 10-year-old child with diabetes was about one year. Diagnosis at age 30 carried a life expectancy of about four years. A newly diagnosed 50-year-old might live eight more years.” (Probably, those 50-year-olds really had type 2.)
In the 1920s, insulin was discovered and became available for use. Life expectancy with type 1 went up dramatically. But when I started nursing in the 1970s, it was still common for people with type 1 to die before age 50.
With better insulins, home testing, and lower-carbohydrate diets, people live longer. A study from the University of Pittsburgh, published in 2012, found that people with Type 1 diabetes born after 1965 had a life expectancy of 69 years. This compares to a life expectancy at birth of roughly 76 years for men and 81 years for women in the general population in the U.S.
A study of about 25,000 people with type 1 in Scotland found that men with type 1 diabetes lose about 11 years of life expectancy, and women about 13 years compared to those without the disease.
According to WebMD, “Heart disease accounted for the most lost life expectancy among type 1 diabetics, affecting 36% of men and 31% of women.”
A lot depends on glucose control. Well-controlled diabetes may have little effect on lifespan. A University of Tennessee study found a 44% reduction in overall risk of death for every 10% reduction in a person’s hemoglobin A1C. So reducing A1C from, say, 7.5% to 6.5% would cut risk of early death in half.
And it is possible to do even better. Dr. Richard Bernstein, author of Dr. Bernstein’s Diabetes Solution, was diagnosed with type 1 at age 12. He is now 85 and still working out, practicing medicine, writing books and looking good. He worked very hard to accomplish this, self-testing as many as eight times a day. By keeping his glucose in a normal range, he has had an exceptional life, despite all the needle sticks.
Not just glucose
Note that many early deaths in diabetes come from heart disease and strokes. Living longer with diabetes, then, is not only about reducing glucose, but about taking care of the heart.
Reducing blood pressure might be as important as controlling glucose when it comes to heart disease and stroke. Blood pressure can be treated with many different classes of medications. Healthy eating, relaxation and exercise also bring pressure down. Stopping smoking should be the highest priority for people with diabetes. Smoking raises blood pressure and strains the heart.
You might wonder which drugs seem best for life expectancy. Current treatment guidelines call for insulin, one or more blood pressure medicines, usually a statin drug to lower cholesterol, and sometimes aspirin to prevent blood clots in the heart or brain. Although they may have harmful side effects, all of these do seem to prolong life, at least in people with type 2 diabetes, in studies like this one from Belgium.
There are also herbal therapies. Diabates.co.uk reported: “Plant-based therapies that have been shown in some studies to have anti-diabetic properties include: aloe vera, bilberry extract, bitter melon, cinnamon, fenugreek, ginger and okra.” I would add apple cider vinegar to that list. Please consult with your doctor before trying any of these for type 1. There may be risk of interactions with your other medicines.
Relaxation and gentle exercise are good for the heart and will make you feel better as well. Longevity is not the only consideration. A long, miserable life is not a worthwhile goal. A life of happiness and love is worth working towards, and it may often turn out longer as well. Loving yourself is good for your heart.
At this point, most people with type 1 can live close to a normal life span, if they work hard enough and get enough support. Without support or without money, it’s harder. Type 2 is more complicated, because more body systems are involved than the pancreatic knockout that is type 1. We’ll look at that next week.