Fight Aging!

Type 2 diabetes is near entirely a lifestyle condition, and can be reversed even in later stages via suitably aggressive dietary and weight loss interventions. Obesity in early adult life is sufficient to cause type 2 diabetes via some combination of mechanisms involving excess fat in the pancreas and increased stress put upon insulin-generating beta cells resident in the pancreas, leading to greater cellular senescence and altered cell behavior. Excess visceral fat is in general harmful to the body via its metabolic activity. There are a range of ways beyond an increased burden of senescent cells by which it can produce chronic inflammation, disruptive to cell function and tissue function throughout the body. As noted here, the consequences of type 2 diabetes and the lifestyle required to sustain it are sizable.

The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy. For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961-2007, median latest follow-up years 1980-2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1,515,718 participants.

For participants with diabetes, we observed a linear dose-response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2.69 when diagnosed at 30-39 years, 2.26 at 40-49 years, 1.84 at 50-59 years, 1.57 at 60-69 years, and 1.39 at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier.

Link: https://doi.org/10.1016/S2213-8587(23)00223-1