Recent trends in life expectancy for people with type 1 diabetes in Sweden.
Level 3 - non-randomized controlled study
Nationwide registry-based retrospective cohort study
PubMed 27044338 · doi:10.1007/s00125-016-3914-7
What was done
Investigators linked data from the Swedish National Diabetes Register with national death records to evaluate mortality changes from 2002 to 2011 in 27,841 adults aged 20 years and older with type 1 diabetes (194,685 person-years; 2,018 deaths). Abridged period life tables were constructed using Chiang's method to calculate remaining life expectancy at age 20 for 2002–2006 versus 2007–2011. Cox proportional hazards models were used to determine trends in overall and cause-specific mortality.
What was found
- For men with type 1 diabetes, remaining life expectancy at age 20 increased significantly from 47.7 years (95% CI 46.6, 48.9) in 2002–2006 to 49.7 years (95% CI 48.9, 50.6) in 2007–2011. - For women with type 1 diabetes, remaining life expectancy at age 20 showed no significant change: 51.7 years (95% CI 50.3, 53.2) in 2002–2006 versus 51.9 years (95% CI 50.9, 52.9) in 2007–2011. - Cardiovascular mortality decreased significantly in both sexes, with an annual hazard ratio of 0.947 (95% CI 0.917, 0.978) for men and 0.952 (95% CI 0.916, 0.989) for women.
Why it matters
This study demonstrates that while cardiovascular mortality reductions have extended life expectancy for men with type 1 diabetes, these survival gains have not translated to women, identifying an important sex disparity in diabetes care outcomes.
Limits
The study was conducted in adult Swedish registry participants (age 20 and older), limiting direct generalizability to pediatric populations or other healthcare settings. Period life tables project remaining life expectancy based on cross-sectional mortality rates rather than following a true longitudinal cohort across a lifetime. The abstract does not provide details on non-cardiovascular causes of death, glycemic control, or pharmacological differences that might explain the lack of gain in women.
Cited by
- supports Patients with type 1 diabetes have a life expectancy reduced by 10 to 20 years and have a tenfold higher risk of cardiovascular disease.