Good news – life expectancy is on the rise

New research shows that people with type 2 diabetes are living longer, suggesting that health management strategies developed to prevent potentially deadly complications like heart attack and stroke may be working.

A global study of 16 high-income countries, led by researchers at the Baker Heart and Diabetes Institute, reveals that death rates for people with type 2 diabetes are declining, including in Australia.

The strongest declines were seen in the Asian countries included in the study – Hong Kong, South Korea, Taiwan, and Singapore.

Published in the scientific journal The Lancet Diabetes and Endocrinology, the research also shows that the life expectancy gap between people with type 2 diabetes and those without the condition is narrowing in about half of the places assessed.

Although this narrowing was not observed in Australia, where the decline in death rates was about 2 per cent for people with diabetes, a similar reduction to those without the condition.

Researchers examined 21 million deaths in people with diagnosed diabetes in 16 high-income countries from 1995 to 2016.

It was the first time this data – generated through improvements in population health records – could be assessed to give a clear picture of changes to diabetes death rates internationally.

Head of Diabetes and Population Health at the Baker Institute, Professor Dianna Magliano OAM says the findings suggest that diabetes care is continuing to improve, at least in the highincome countries like Australia, the US, Canada, and Denmark represented in this study.

“Interestingly, in the last decade several countries in Asia have implemented a whole of country diabetes management strategy, labelled by some as the ‘War on Diabetes’,” Professor Magliano says.

“Our findings suggest this intensive, coordinated and multipronged strategy to manage diabetes better could be working, as this region is where we saw the biggest reduction in diabetes death rates.”

The findings follow another global study published last year, also led by Professor Magliano, which shows the annual rate of new cases of adults diagnosed with type 2 diabetes (diabetes incidence) is stable or falling in many highincome countries, including Australia.

Professor Magliano says both findings are reason for cautious optimism.

“Mortality rates are an important indicator of access to quality healthcare. Our findings suggest that we may be starting to reap the benefits of better education and disease management programs,” she says.

“Public health campaigns to reduce tobacco use, improve diet and increase physical activity has certainly led to reductions in levels of some risk factors, including smoking, high blood pressure and cholesterol.

“The use of blood pressure and cholesterol lowering medications ➤

for the prevention of cardiovascular disease in people with diabetes has also increased in the last decades. This is critical because cardiovascular disease is a leading cause of death in people with type 2 diabetes.

“Plus, there have been significant advances in medical interventions and care for individuals with acute cardiovascular events such as heart attack and stroke.”

Baker Institute diabetes researcher and clinician Professor Jonathan Shaw, a co-author of the research, says further increases to life expectancy require continued improvement in the prevention and management of diabetes and its complications.

“A crucial tool in controlling complications of diabetes is the development of good quality risk predictors which facilitate allocation and targeting of appropriate therapies, as well as the development of new interventions,” Professor Shaw says.

“At the Baker Institute, we are currently leading a major project in

this area thanks to a $4.8 million Federal Government grant.

“So, while there is still a long way to go to control the many risks associated with diabetes, these findings provide promising evidence that we are moving in the right direction.”

Simple ways to reduce your risk of diabetes complications:

• Make sure that you are up to date with regular checks of your eyes, feet, kidney function, cholesterol, and blood pressure. ❏ Link up with the full range of diabetes health professionals in your area through your doctor or Diabetes Australia.
• Use any medication strictly as prescribed. Don’t make changes to your diabetes tablets without talking to your doctor about it first.
• Be physically active as often as you can and sit less. Work out ways that you can maintain this activity.
• Have a healthy eating plan. Choose healthy foods as well as suitable amounts.
• Keep a positive mental attitude and seek advice if you are anxious or depressed from your doctor, or other organisations such as Beyond Blue or Lifeline. ❏ Seek medical advice if you feel unwell.
• Consider joining a support group.