Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease.

@article{citeulike:2205748, abstract = {BACKGROUND: Diabetes mellitus is a recognized risk factor for cardiovascular disease (CVD) and mortality. However, limited information exists on the association of diabetes with life expectancy with and without CVD. We aimed to calculate the association of diabetes after age 50 years with life expectancy and the number of years lived with and without CVD. METHODS: Using data from the Framingham Heart Study, we built life tables to calculate the associations of having diabetes with life expectancy and years lived with and without CVD among populations 50 years and older. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to CVD, and CVD to death), stratifying by the presence of diabetes at baseline and adjusting for age and confounders. RESULTS: Having diabetes significantly increased the risk of developing CVD (hazard ratio, 2.5 for women and 2.4 for men) and of dying when CVD was present (hazard ratio, 2.2 for women and 1.7 for men). Diabetic men and women 50 years and older lived on average 7.5 (95\% confidence interval, 5.5-9.5) and 8.2 (95\% confidence interval, 6.1-10.4) years less than their nondiabetic equivalents. The differences in life expectancy free of CVD were 7.8 and 8.4 years, respectively. CONCLUSIONS: The increase in the risk of CVD and mortality from diabetes represents an important decrease in life expectancy and life expectancy free of CVD. Prevention of diabetes is a fundamental task facing today's society in the pursuit of healthy aging.}, address = {Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. oscar.franco@unilever.com}, author = {Franco, O. H. and Steyerberg, E. W. and Hu, F. B. and Mackenbach, J. and Nusselder, W. }, citeulike-article-id = {2205748}, comment = {It is well known that type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular disease (CVD) and CVD mortality. Previously, it has been difficult to quantify the exact effect of a diagnosis of T2DM on life expectancy. Using data from the Framingham Heart Study, investigators calculated the effect of having T2DM on life expectancy among persons at least 50 years of age. Their analysis demonstrated that having T2DM increased the risk of having CVD about 2.5 fold in men and women, and increased the risk of dying when CVD was present about 2 fold (with an effect that was slightly higher in women than in men). These hazard ratios are similar to those that have been seen in other observational studies. Diabetic men aged 50 and older lived on average 7.5 years less than those without T2DM, and diabetic women aged 50 and older lived on average about 8.2 years less than those without T2DM. There was no significant difference between the years spent alive with established CVD between subjects with and without T2DM, meaning that once CVD is established, the rate of death is the same whether or not T2DM is present. While these data need to be validated in other more racially and ethnically diverse cohorts, they suggest that a diagnosis of T2DM has a significant impact on the incidence of CVD and a profound negative effect upon life expectancy—somewhere around 5-10 years. Presumably, life expectancy among Americans over the age of 50 could be increased by decreasing the incidence of T2DM or by decreasing the risk of developing CVD, perhaps by aggressive treatment of other CVD risk factors, once a diagnosis of T2DM has been made. –Michael J. Bloch, M.D. }, doi = {10.1001/archinte.167.11.1145}, issn = {0003-9926}, journal = {Arch Intern Med}, keywords = {chd, diabetes, epidemiology}, month = {June}, number = {11}, pages = {1145--1151}, posted-at = {2008-01-08 00:26:20}, priority = {2}, title = {Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease.}, url = {http://dx.doi.org/10.1001/archinte.167.11.1145}, volume = {167}, year = {2007} }

TY - JOUR ID - citeulike:2205748 L3 - citeulike-article-id:2205748 TI - Associations of diabetes mellitus with total life expectancy and life expectancy with and without cardiovascular disease. JF - Arch Intern Med VL - 167 IS - 11 SP - 1145 EP - 1151 AD - Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. oscar.franco@unilever.com SN - 0003-9926 N2 - BACKGROUND: Diabetes mellitus is a recognized risk factor for cardiovascular disease (CVD) and mortality. However, limited information exists on the association of diabetes with life expectancy with and without CVD. We aimed to calculate the association of diabetes after age 50 years with life expectancy and the number of years lived with and without CVD. METHODS: Using data from the Framingham Heart Study, we built life tables to calculate the associations of having diabetes with life expectancy and years lived with and without CVD among populations 50 years and older. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to CVD, and CVD to death), stratifying by the presence of diabetes at baseline and adjusting for age and confounders. RESULTS: Having diabetes significantly increased the risk of developing CVD (hazard ratio, 2.5 for women and 2.4 for men) and of dying when CVD was present (hazard ratio, 2.2 for women and 1.7 for men). Diabetic men and women 50 years and older lived on average 7.5 (95% confidence interval, 5.5-9.5) and 8.2 (95% confidence interval, 6.1-10.4) years less than their nondiabetic equivalents. The differences in life expectancy free of CVD were 7.8 and 8.4 years, respectively. CONCLUSIONS: The increase in the risk of CVD and mortality from diabetes represents an important decrease in life expectancy and life expectancy free of CVD. Prevention of diabetes is a fundamental task facing today's society in the pursuit of healthy aging. KW - chd KW - diabetes KW - epidemiology N1 - It is well known that type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular disease (CVD) and CVD mortality. Previously, it has been difficult to quantify the exact effect of a diagnosis of T2DM on life expectancy. Using data from the Framingham Heart Study, investigators calculated the effect of having T2DM on life expectancy among persons at least 50 years of age. Their analysis demonstrated that having T2DM increased the risk of having CVD about 2.5 fold in men and women, and increased the risk of dying when CVD was present about 2 fold (with an effect that was slightly higher in women than in men). These hazard ratios are similar to those that have been seen in other observational studies. Diabetic men aged 50 and older lived on average 7.5 years less than those without T2DM, and diabetic women aged 50 and older lived on average about 8.2 years less than those without T2DM. There was no significant difference between the years spent alive with established CVD between subjects with and without T2DM, meaning that once CVD is established, the rate of death is the same whether or not T2DM is present. While these data need to be validated in other more racially and ethnically diverse cohorts, they suggest that a diagnosis of T2DM has a significant impact on the incidence of CVD and a profound negative effect upon life expectancy—somewhere around 5-10 years. Presumably, life expectancy among Americans over the age of 50 could be increased by decreasing the incidence of T2DM or by decreasing the risk of developing CVD, perhaps by aggressive treatment of other CVD risk factors, once a diagnosis of T2DM has been made. –Michael J. Bloch, M.D. AU - Franco, OH AU - Steyerberg, EW AU - Hu, FB AU - Mackenbach, J AU - Nusselder, W PY - 2007/06/11/ UR - http://dx.doi.org/10.1001/archinte.167.11.1145 ER -