Take care of yourselves! The Effect of Diabetes on Longevity

Most people today are aware of what diabetes is and how it is treated.  The formal name is diabetes mellitus, now commonly called diabetes (sugar diabetes in the dark ages).  Diabetes occurs when the amount of glucose in the blood exceeds the amount of insulin produced by the pancreas.  Insulin is a hormone responsible for assisting the glucose into the cells to be used as fuel.  Type I insulin is also referred to as juvenile or insulin dependent diabetes; the pancreas no longer produces insulin.  Type II is more common and easier to treat; the pancreas is not producing enough insulin.   

Awareness and improved medications (including insulins) have made living with diabetes much easier.  Insulin administration and glucose testing have also drastically improved; the insulin pump and continuous glucose monitors simplify the lives of Type I diabetics.  The problem often lies with persons not embracing a restrictive diet or improved exercise regimen.  When diabetes is not controlled, complications result.  Diabetes affects the basement membrane in cells.  Poorly controlled diabetes can deteriorate the vascular system (vasculopathy), eyes (retinopathy), renal function (nephropathy) and nerve receptors (neuropathy).  Ultimately complications may cause blindness, renal failure, and even gait disorder, due to advanced neuropathies.  Vasculopathy complications will negatively impact a heart that is already impaired with coronary artery disease.  This shows why the combination of diabetes and previously existing vascular disease will increase the mortality multiplier.  As poorly controlled diabetes continues to affect quality of life, the life expectancy will continue to deviate from standard.  

​Mortality of both type I and II diabetes has steadily improved since 1980.  Of course, the most important information when underwriting diabetes is the control of the glucose and the affect complications are having on ADLs (activities of daily living).  Levels of glucose control in the past simply revolved around lab analysis of the glucose level; for accurate levels, the person tested had to be fasting.  In the 1980s, testing advanced to include hemoglobin A1c (A1c for short) which gave the average glucose level for the past 2-3 months.  This was especially important because a single glucose level would be impacted by that days dietary intake only, but an average level gave a very real representation of what the actual glucose levels were.  The control will affect the complications and the complications will affect the aging process and therefore longevity.