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People With Diabetes Living Longer Without Disability

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People With Diabetes Living Longer Without Disability

People with diabetes and other chronic health conditions are living longer without disability, according to new research published in the journal PLOS Medicine.

Many of the headlines about the widespread health effects of diabetes and other chronic conditions can be demoralizing or even depressing — such as the fact that diabetes-related deaths in the United States stayed high in 2021 after a sharp increase in 2020, or that undiagnosed liver disease appears to be common in people with type 2 diabetes, or that chronic kidney disease often progresses quickly in people with diabetes. So it can be easy to lose sight of positive developments, such as advances in diabetes treatments and in treatments for diabetes-related complications. For example, a diabetes drug first approved in the United States just over a decade ago — Victoza (liraglutide) — was found in a recent study, along with basal (long-acting) insulin, to be one of the best treatment options for type 2 diabetes when metformin isn’t enough to adequately control blood glucose levels. And recent research has also shown that diabetic kidney disease may respond best to early treatment with multiple drugs — a strategy that wasn’t on the table just a few years ago, due to the lack of evidence supporting what we now know are very effective drugs for slowing kidney disease progression.

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For the latest analysis, researchers compared participants in two different large studies — known as the Cognitive Function and Ageing Studies — conducted decades apart in England. Both studies followed the same design, and involved participants ages 65 and older. The first study took place from 1991 to 1993, while the second took place between 2008 and 2011 — with participants followed for two years in each study. To assess disability, the researchers used a measure called the Townsend activities of daily living scale. This scale isn’t focused on any particular health condition that causes disability, so it can be used to assess disability that may be related to many different health conditions. Participants in the latest analysis had at least one chronic health condition, including diabetes, arthritis, cognitive impairment, coronary artery disease (CAD), peripheral vascular disease (PVD), breathing problems, hearing problems, or vision impairment.

Using disability ratings, the researchers calculated what’s known as disability-free life expectancy — how long a person lives before they reach a level of significant disability. They also calculated participants’ actual life expectancy — how long they lived. In both cases, they adjusted for a number of differences between participants between the first and second studies — such as the fact that participants’ average age at study enrollment was 75.6 in the first study, and 76.4 in the second study.

Increases seen in disability-free life expectancy 

Between the two different study periods, cognitive impairment was the only chronic health condition that actually saw a decrease in prevalence — but it also saw a decrease in remaining disability-free years at age 65 for people with the condition, both men and women. For all the other chronic health conditions, disability-free life expectancy at age 65 stayed about the same or increased between the two study periods. The difference was particularly notable for coronary artery disease — people with this condition saw not only an increase in disability-free years by an average of 2.7 years, but also experienced an absolute drop in years with disability, by 0.8 years on average.

Among participants with diabetes, there was an increase of 3.4 disability-free years at age 65 for men (from 8.3 to 11.7 years) and 3.1 disability-free years at age 65 for women (from 5.6 to 8.7 years) between the two study periods. But the average number of years spent with disability also increased by 0.6 years for men (from 3.2 to 3.8 years), while it decreased by 0.2 years for women (from 9.3 to 9.1 years). The total life expectancy at age 65 increased in both men and women between the two study periods — from 11.5 years to 15.5 years for men, and from 14.9 years to 17.8 years for women.

“While these findings are positive, we also found a decline in the percentage of remaining years spent disability-free for men and women with cognitive impairment,” the researchers wrote. “Given that cognitive impairment was also the only [chronic health condition] where prevalence decreased, this is a cause for concern and requires further investigation.”

Want to learn more diabetes basics? Read “Welcome to Diabetes” for type 2, “Type 1 Diabetes Questions and Answers” for type 1, and “Gestational Diabetes: Are You at Risk?” for gestational diabetes.

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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