Thanks to better treatment for the disease and its resulting complications, Americans with insulin dependent diabetes now have a longer life expectancy than those diagnosed in the 60s and 70s. But diabetics' mortality rates are still startlingly higher than that of the general population.
There's good news and bad news for Type 1 diabetics, according to the University of Pittsburgh. The good news is that death rates for the disease have dropped considerably since the mid-70's, with the advent of better glucose monitors, insulin pumps and newer insulins such as long acting insulin. "The encouraging thing is that, given good [blood sugar] control, you can have a near normal life expectancy," says Dr. Trevor Orchard from the university's Graduate School of Public Health, "What we're seeing now is incredibly encouraging."
The bad news is that the mortality rate for people with Type 1 diabetes is still 7 times higher than that of the general population. More bad news for women – the death rate for females with Type 1 diabetes is almost twice that of men - 13 times higher than the mortality rate for women without the disease. And there's bad news for blacks with Type 1 diabetes - they have a lower 30-year survival rate than whites – 57% versus 83%. The researchers aren't sure how to explain the higher risk for women and blacks, but believe it may be related to a genetic tendency for heart disease and high blood pressure in blacks, and an increased tendency for heart disease in diabetic women.
Type 1 diabetes, also called insulin dependent diabetes, is an auto-immune disease in which a misguided immune system attacks and destroys the insulin-producing cells in the pancreas. Insulin is a hormone which controls the amount of glucose (sugar) in the blood by coordinating its use by different parts of the body. People with the condition make little or no insulin, and must rely on insulin injections to control their blood sugar. About 10% of people with diabetes, or 700,000 Americans, have Type 1 diabetes. It usually occurs in people under 40, often beginning in childhood. The other 90% have Type 2 diabetes, a condition in which the body can produce insulin, but can't use it properly.
Type 1 diabetes can be more difficult to control than Type 2. Insulin injections are less effective than naturally produced insulin, and blood sugar levels can swing between too low and too high. High blood sugar puts diabetics at risk of long-term complications like heart disease and kidney failure. Low blood sugar can result in convulsions, coma and even death. For those with type 1 diabetes, insulin therapy with a combination of short and long acting insulin is essential to keep blood sugar levels stable, especially after meals and overnight.
The researchers stress that, overall, the study results left them feeling optimistic. "Diabetes care has improved in many ways over the last couple of decades, and as a result people are living longer," says Barbara Araneo form the Juvenile Diabetes Research Foundation, "Managing and taking good care of your diabetes is the surest way to reduce your risk of developing complications later in life."
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