Americans with type 1 diabetes are living longer, healthier lives with improved technology for monitoring and regulating blood sugar. However, women and African Americans have not made as much progress as men and Caucasians. A study from the University of Pittsburgh, Pennsylvania, evaluated the long-term effects of treatment advances.
Self-monitoring of blood glucose, A1C testing, and ACE inhibitors were the main improvements in diabetes care of the 1980's and 1990's, according to Reference 1. The researchers used data from the Allegheny County Type 1 Diabetes Registry to analyze how mortality rates have changed over time. The 1,075 subjects were divided into three groups by date of diagnosis: 1965–1969, 1970–1974, and 1975–1979. All were less than 18 years old when they were diagnosed. As of January 2008, 279 deaths had occurred in the subjects. Standard mortality ratios were calculated at 30 years after diagnosis.
Standard mortality ratios improved stepwise for the three groups, demonstrating that better technology leads to longer lives for type 1 diabetics. However, more progress is needed, especially for women. When data for males and females were analyzed separately, diabetic women died at 13 times the rate of age-matched women in the general population, while diabetic men died at 5 times the rate of age-matched men.
Data analysis by race was complicated by higher death rates for African Americans in the general population. The 30-year survival rate for Caucasians diagnosed with type 1 diabetes as children was 82.7 percent, while the corresponding survival rate for African Americans was only 57.2 percent. Diabetes was not the main reason for this difference, but the authors suggested there is still much room for improvement in diabetes care for racial minorities as well as for women.
A separate study by Dr. George L. King of Harvard Medical School showed that approximately 20 percent of type 1 diabetics live for at least 50 years with no significant complications. These individuals had good control of their blood sugar, but King said there's more to it. Vigorous physical exercise, at least 45 minutes three times a week, and a positive attitude were two factors characteristic of the healthiest long-term diabetics.
References:
1. Secrest AM et al, “All-cause mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes”, Diabetes Care 2010; 33: 2573-79.
2. Dr. George L. King's study reported online:
http://diabetes.webmd.com/news/20110329/why-some-may-avoid-type-1-diabetes-complications
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.