From King of Prussia, Pennsylvania, USA:
I noticed an article in the August 9th edition of the What's New page concerning an abrupt increase in the incidence of IDDM in children in Canada. In that report the author mentions that the life expectance of people with IDDM is reduced by 30%. Is that statistic still true nowadays given the availability of in-home monitoring, new insulins, etc.?
One of the modern miracles of the 20th century was insulin therapy for type 1 diabetic patients. With insulin availability, the case fatality rate of up to 80% each year dropped precipitously below 5%. There is nowadays strong evidence that the major improvement in the life expectancy of type 1 diabetic patients in the past 50 years has been the result of a reduction in the mortality associated with the onset of the disease and shortly afterwards. This avoidance of early deaths probably explains the observed similarity between the survival of young type 1 subjects compared with the general population for the first 15 years of disease duration. Moreover, children, with a slight excess of females, with onset at adolescent "transition" age, carry an increased mortality, probably reflecting personal, family, and medical difficulties in dealing with the particular psychosocial characteristics of teenagers. These difficulties can lead to poor metabolic control, acute metabolic complications of diabetes such as DKA or hypoglycemia, and infections. This is an area where much attention is needed in the provision of childhood diabetic care and it requires a thorough and sensitive multidisciplinary approach.
In long term mortality, studies so far appear to indicate that type 1 diabetes, when chronic complications are present (mainly if kidney disease), despite advances in care and refinements of insulin treatment and metabolic control, still carries an unacceptable high mortality rate.
Last Updated: Tuesday April 06, 2010 15:09:00
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