Associations of Diabetes Mellitus With Total Life Expectancy and Life Expectancy With and Without Cardiovascular Disease

Abstract

Globalization of the Western lifestyle led to diabetes mellitus being a major and progressive health care problem worldwide.^1,2 By 2000, there were more than 171 million individuals with diabetes in the world, and this number is expected to double in 25 years.² Many years of research have shown that diabetes poses an increased risk of mortality and morbidity among those who have it.³ For instance, diabetic subjects have a greater than 2-fold–increased risk of developing cardiovascular disease (CVD).⁴ However, there is limited information about the potential association of diabetes with total life expectancy (LE), LE with CVD, and LE without CVD. This association is not easy to predict, since the associations of different risk factors for CVD with LE and the association of LE with CVD can follow unexpected directions. For instance, hypertension is associated with shorter LE and more years of life spent with CVD.⁵ On the other hand, smoking is associated with a shorter LE but also with a decrease in LE with CVD,⁶ since smokers generally experience higher levels of non-CVD mortality at younger ages.⁶