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Diabetes diagnosis under 10 cuts life expectancy by 16 years

Patients with diabetes who are diagnosed before the age of 10 will lose an average of 16 years from their life, according to a new study.

The research, which included 27,000 type 1 diabetes patients, saw that those diagnosed at a younger age were 30 times more likely to develop coronary heart disease and acute myocardial infarction, with women facing the highest risks, when compared with matched controls. 

Researchers have urged for a greater focus on cardio-protection in people with early-onset type 1 diabetes to combat these risks.

The large observational study from Sweden followed over 27,000 individuals with type 1 diabetes and more than 135,000 matched controls for an average of 10 years.

The average age of participants was 29 years, and 56% were men. Only small differences were seen in education and marital status between the cohorts, while the controls earned £405 more per year.

The paper, published in The Lancet, found that patients diagnosed before the age of 10 lost an average of 16 years from their life expectancy, with men losing 14.2 years and women losing 17.7 years.

In comparison, for patients diagnosed between 26 and 30 years, women lost 10.1 and men lost 9.4 years.

Researchers also saw that on average, patients with type 1 diabetes and disease onset before 10 years had a 30-times increased risk of coronary heart disease and acute myocardial infarction, when compared with controls.

But these risks were even higher in women meeting the same criteria, with a 60-times increased risk of coronary heart disease and 90-times increased risk of acute myocardial infarction.

The researchers said: ‘Age at onset of type 1 diabetes is an important determinant of survival, as well as all cardiovascular outcomes, with highest excess risk in women. Greater focus on cardioprotection might be warranted in people with early-onset type 1 diabetes.’

Study author Professor Naveed Sattar, from the University of Glasgow’s Institute of Cardiovascular and Medical Sciences, said: ‘While the absolute risk levels are higher in individuals who develop diabetes when older, simply due to age being a strong risk factor, the excess risk compared to healthy controls is much higher in those who developed diabetes when younger.

‘If this higher excess risk persists over time in such individuals, they would be expected to have highest absolute risks at any given subsequent age. Indeed, those who develop type 1 diabetes when under 10 years of age experience the greatest losses in life expectancy, compared to healthy controls. This is something we did not fully appreciate before.’

London GP Professor Azeem Majeed, head of primary care and public health at Imperial College London, said: 'We know that duration of type 1 diabetes is an important risk factor for diabetes complications. This paper shows that age of onset of type 1 diabetes is also important.

'The increases in risk in people with onset of type 1 diabetes at a young age are very striking and reinforce the need for good diabetes management in this group, as well as the need to address risk factors for cardiovascular disease such as high blood pressure, lipids, smoking, and physical inactivity.'

Researchers identified five distinct types of diabetes earlier this year, which they argued should replace the type 1 and 2 classification to ensure patients are treated and managed effectively. 

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