Type 2 diabetes associated with reduction in disability-free life years

1. In a retrospective review of over 20 000 adults over the age of 50, adults with type 2 diabetes (T2DM) experienced a significant reduction in total and disability-free life-years compared to adults without T2DM.

Evidence Rating Level: 3 (Average)

Study Rundown: There has been a significant increase in the number of years that an average person lives with T2DM due to the increasing life expectancy in diabetic patients. However, there is limited data on estimates of disability-free years lost to T2DM. The objective of this large cohort study was to quantify the impact of diabetes on the state of disability and longevity in a population of adults in the United States.

The study analyzed self-reported data from over 20 000 adults over the age of 50 as part of a prospective, biannual survey from 1998 to 2012. Specifically, adults with T2DM developed disabilities approximately 6 years earlier and experienced an average of 1 to 2 years more in a disabled state. This effect was seen in both men and women in this cohort. The results of this study . The strength of the study is the large sample size, which provided a representative cohort of the United States population and improves external generalizability. The study was limited by the use of self-reported data, which may introduce recall bias in both incidences of T2DM and disability.

Click to read the study in Diabetes Care

Relevant Reading: Association of functional decline with subsequent diabetes incidence in U.S. adults aged 51 years and older: the Health and Retirement Study 1998-2010

In-Depth [retrospective cohort]: Patient data from the Health and Retirement Study, a prospectively-collected, population-based health survey in the United States were reviewed. The main outcomes investigated were self-reported rates of T2DM and disability, defined as loss of mobility, difficulty performing daily activities, and/or difficulty performing instrumental daily activities. A health state transition simulation model was used to compare the disability outcomes of participants with and without diabetes. A total of 20 008 adults over the age of 50 were followed from 1998 to 2012. At the conclusion of the study, patients with T2DM demonstrated a significant reduction in total disability-free years compared to the non-T2DM population. Overall, starting at age 50 years, the cohort diagnosed with T2DM died 4.6 years earlier and developed disability 6 to 7 years earlier than those in the non-T2DM cohort. The association between T2DM and decreased disability-free life years were significant in subgroup analyses among both men and women.

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