When it comes to living a long, healthy life with diabetes, numbers can be especially important, says a new study published in the medical journal JAMA Network Open. The authors report that people with diabetes who reach specific treatment goals as defined by certain numbers called biomarkers can appreciably increase their life expectancy — in some cases by as much as a decade.
Ever since the invention of the first practical oral thermometer in the mid-19th century, doctors have been assessing their patients’ health through tests that show results on a numerical scale. Today, a routine office exam blood test can return well over a dozen numbers. These are often referred to as “biomarkers” — identifiable and measurable components of a cell that can be used to determine a person’s health and likelihood of developing health problems.
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Important biomarkers in type 2 diabetes
The new study, which was conducted by a team headed by Hui Shao, MD, of the College of Pharmacy, University of Florida, Gainesville, found four biomarkers to be of particular importance in determining the life expectancy of people with type 2 diabetes. These were:
A blood test that measures blood sugar control over the preceding two to three months.
Body-mass index or BMI, is a person’s weight in pounds divided by the square of their height in feet. It is used to indicate levels of fat that might lead to health problems. A BMI of 30 or above is considered obese.
Specifically, systolic blood pressure, or SBP (the top number).
Often called “bad” cholesterol, high LDL levels have been associated with greater rates of heart disease and stroke.
The researchers analyzed data from the U.S. National Health and Nutrition Examination Survey (2015-2016) on 421 Americans with type 2 diabetes and compared those in the highest quartile (one-fourth) of the four biomarkers with those in the bottom quartile. A little less than half (194) were women, and they ranged in age from 51 to 80 (the average age was 65.6).
Hitting treatment targets linked to longer life
What they found was that people with diabetes who were successful in hitting treatment targets in HbA1c, BMI, SBP, and LDL-C considerably prolonged their life expectancy For example, those who began by being classified in the highest quartile for HbA1c (an average of 9.9%) but were able to bring the number into lowest quartile (5.9%) added 3.8 years to their life expectancy. Patients in the top HbA1c quartile who didn’t do quite that well, but who lowered their number to the third quartile (7.7%), still added 3.4 years to their life expectancy.
Similar results were reported with the other biomarkers. As for HbA1c, those in the top BMI quartile who reduced their numbers into lower quartiles raised their life expectancy. Those who achieved the third quartile added 2.0 years, those who achieved the second added 2.9, and those who reached the first quartile (an average BMI of 24.3) added 3.9 years. The results for blood pressure and LDL cholesterol were not as impressive but still significant. Compared with the top quartile of blood pressure, those in the third quartile added 1.1 years to life expectancy, those in the second added 1.5, and those in the first added 1.9. With LDL cholesterol, the added life expectancy was measured in months, not years. Compared with those who were in the highest quartile, those in the third added 0.5 years, those in the second added 0.7, and those in the first added 0.9 years. The researchers also noted that the benefits of better biomarker control were even higher in the younger age group, indicating the importance of getting an early start on lifestyle improvements.
In summation, the authors said, “Better control of biomarkers can potentially increase the life expectancy (LE) by 3 years in an average person with Type 2 diabetes in the U.S. For individuals with very high levels of HbA1c, SBP, LDL-C, and BMI, controlling biomarkers can potentially increase LE by more than 10 years…. Our findings can be used by clinicians and patients in selecting optimal treatment goals, to motivate patients in achieving them, and to measure potential health benefits for interventions and programs to improve diabetes care in the U.S.”