Epidemiologic Data on Excess Mortality and Life Expectancy in Insulin-Dependent Diabetes Mellitus — Critical Review¹)

Abstract

Generalizations of prognosis with regard to insulin-dependent diabetes (IDDM) in epidemiological statistics are impaired not only by great intraindividual variations, but also due to methodical difficulties. Due to recent prognostic studies IDDM, particular in young age, must be considered as a rather serious disease with a 5 to 10 fold higher excess mortality in comparison with the general population. There are only few exact data about the extent of life shortening. Age of onset represents the most significant factor in life shortening. The younger the patient is at the age of onset the shorter he lives. From about 70 years onward diabetes has little or no effect on longevity. Whether the prognosis of IDDM has improved within the last decades remains uncertain. Long-term studies clearly indicate that IDDM is compatible also with a long life in a good health. Why many diabetics develop life shortening complications and why some patients do not cannot be answered with conclusive evidence.

A new perspective on mechanisms governing skeletal complications in type 1 diabetes

“…Moreover, the incidence of T1D is increasing 3–5% annually worldwide, possibly owing to unidentified environmental factors . T1D is also associated with an increase in mortality at every age; by some estimates, mortality rates are 5–10 times higher among those with the disease . The early nature of T1D onset, with average diagnosis age being 14 years, results in a lifetime exposure not only to erratic blood glucose levels but also to increased risk of complications .…”

“…[6][7][8][9][10] T1D is also associated with an increase in mortality at every age; by some estimates, mortality rates are 5-10 times higher among those with the disease. 2,5,11 The early nature of T1D onset, with average diagnosis age being 14 years, results in a lifetime exposure not only to erratic blood glucose levels but also to increased risk of complications. 12,13 The list of diabetes-related complications is extensive and involves nearly every organ system, including the skeleton.…”

Epidemiological evidence of a relationship between type‐1 diabetes mellitus and cancer: A review of the existing literature

“…Although the cause of this is unclear, contributing factors appear to relate to the interplay between genes and the environment, and to better diagnosis and monitoring of the disease within countries that previously did not undertake such work 4, 5. Type‐1 diabetes is associated with an increase in mortality at every age, with some estimates placing it at five to ten times higher among those with the disease 6. The excess mortality found within this group is related primarily to metabolic complications of diabetes which result in increased rates of cardiovascular and renal disease 7…”

“…4,5 Type-1 diabetes is associated with an increase in mortality at every age, with some estimates placing it at five to ten times higher among those with the disease. 6 The excess mortality found within this group is related primarily to metabolic complications of diabetes which result in increased rates of cardiovascular and renal disease. 7 Investigations attempting to detail the link between diabetes mellitus, hyperglycaemia and cancer started in the late 1800s with the work of Freund 8 and Tuffier.…”

Metformin ameliorates experimental diabetic periodontitis independently of mammalian target of rapamycin (mTOR) inhibition by reducing NIMA‐related kinase 7 (Nek7) expression

“…As complications develop, diabetes mellitus compromises life expectancy and quality . Diabetic periodontitis has been recognized as a crucial complication in the oral cavity.…”