Multiple long-term conditions by age 50 in diabetes
For this study, researchers analyzed medical data from more than 46 million U.K. adults 20 years and older using the National Bridges to Health Segmentation Dataset.
More than 3 million of the study participants had type 1, type 2, or other forms of diabetes.
Upon analysis, researchers found that by the age of 50, about one-third of study participants with diabetes had at least three MLTCs. Conversely, those without diabetes did not reach having three MLTCs until ages 65-70.
Scientists also found that the average onset age for at least two MLTCs was 66-67 years for participants with diabetes. Additionally, the younger a person was diagnosed with diabetes, the more severe their levels of MLTCs would be as they aged.
“Multiple long-term conditions has emerged as one of the most challenging population health threats worldwide,” Edward W. Gregg, PhD, professor in the School of Population Health at RCSI University of Medicine and Health Science in Ireland, professor in the Department of Epidemiology and Biostatistics at Imperial College London, and corresponding author of this study told Medical News Today.
“It’s been considered a problem largely of aging, and although greater lifespans are partly to blame, that does not tell the whole story. We confirmed that this is a major challenge that emerges even in young and middle adulthood,” he added.
Hypertension, CHD, osteoarthritis most frequent conditions
When Gregg and his team examined specific MLTCs, across all ages and genders the most frequently seen MLTCs were:
“We were not surprised that diabetes was associated with MLTCs but we were surprised by the diversity, the severity — ie. the frequency of having 3,4, or 5+ conditions — and the relatively early age onset,” Gregg said.
“Hypertension [and] coronary heart disease were expected. However, the associations with asthma and osteoarthritis were not. The association with depression was expected, but the fact that it accompanied diabetes so frequently in young adulthood was surprising.”
– Edward W. Gregg, PhD
4 years of life lost for each co-occurring condition
The researchers also examined how many years of life did people with diabetes lose due to MLTCs.
Scientists found that participants with more MLTCs had fewer years living with them and died earlier than participants who did not have MLTCs.
For example, researchers found participants with diabetes and three MLTCs lived about 10 years with them, and 5 years less than the general population, while participants with diabetes who had at least five MLTCs lived 5 years with them, and died 6 years earlier than those who did not have MLTCs.
Gregg and his team also found that when young adults with diabetes experience MLTCs, the life years spent and lost was greater.
For example, a person with diabetes and MLTCs by age 40 lost about 4 years of life for each condition compared to those without MLTCs.
“It may be an indication that when these conditions occur in young adulthood they are particularly severe,” Gregg said. “But mostly, chronic conditions tend to do their damage on disability and life expectancy over time, so we need to find ways to stop people from getting an early start on such conditions.”
“Diabetes itself is highly preventable and preventing its onset can help reduce the accumulation of additional conditions,” he continued.
Moreover, the researcher added, “diabetes is also highly manageable and with good control can reduce the development of MLTCs. Next steps are identifying and developing and then testing the impact of interventions that can reduce the development or worsening of MLTCs.”
Why do so many conditions co-occur with diabetes?
After reviewing this study, Pouya Shafipour, MD, a board certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told MNT he was not surprised by its findings.
“This is something that we expect because diabetes and the state of insulin resistance in the body starts way before someone is diagnosed with diabetes,” Shafipour explained. “They’re often in this state of fatty liver, insulin resistance, and that’s when the damage really starts to the body, to all the organs.”
“People with diabetes are at an increased risk of atherosclerotic heart diseaseTrusted Source, cerebrovascular disease (CVA), stroke, retinopathy, neuropathy, kidney disease — several different conditions,” he added. “So it is really a condition that encompasses the entire body, so it’s something that was not surprising at all.”
MNT also spoke with Yu-Ming Ni, MD, a board certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, who agreed with this assessment.
“There [are] many different conditions that diabetes affects,” Ni explained. “We’re talking about a problem in the way the body metabolizes sugar. It’s more than just affecting your sugar levels. It affects your body from top to bottom in terms of your physical functioning and the way the organs work.”
“From a heart standpoint, we often think about heart disease as it includes things like coronary artery disease, risk for heart attack and stroke, high blood pressure,” he continued.
“All of this goes along with diabetes, not only directly caused by the diabetes affecting blood vessel function and organ function, but also in conjunction with diabetes due to underlying metabolic problems, especially obesity. So the findings of the study are not surprising to me. It more just highlights how significant long-standing exposure to diabetes can affect your health in so many different ways.”
– Yu-Ming Ni, MD
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