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Certain groups of people may face higher risks of early mortality and loss of life expectancy years from type 2 diabetes, a real-world population study showed.

In an English cohort, a few specific factors were associated with significantly higher odds of diabetes-related mortality, including:

• Smoking vs not smoking: OR 2.01 (95% CI 1.71-2.36)
• Age at diagnosis <65 years vs ≥65 years: OR 1.56 (95% CI 1.40-1.74)
• Duration with type 2 diabetes over 10 years vs under 10 years: OR 1.21 (95% CI 1.09-1.34)
• Women vs men: OR 1.11 (95% CI 1.00-1.23)
• Living in a deprived area vs not: OR 1.28 (95% CI 1.14-1.42)

While having type 2 diabetes shortens life expectancy compared with the general population, this study showed that women were particularly affected (5.3 years shorter vs 4.5 years for men), reported Adrian Heald, MD, of Salford Royal Hospital in England, during a presentation at the European Association for the Study of Diabetes (EASD) meeting.

"We all know that type 2 diabetes shortens life," Heald said during a press conference. "Perhaps less so, thanks to the greater innovations in diabetes treatments, with cardiovascular reductions associated with those treatments."

"The key message [here] ... is that for women with type 2 diabetes, their lives are shortened more than men and their likelihood of dying is higher than men," he noted.

"Why this is happening is difficult [to understand]," he said, suggesting that it could be due to lipid handling, specifically with how LDL receptors behave.

"It may be that women are not having access to some medications," Heald added. "We interestingly found that women are taking less of the new drugs -- the SGLT2 inhibitors -- than men do. It may also be due to concordance, too -- the degree to which women actually take their medication as opposed to men."

"We don't know why, but we do feel this is a really important finding that's of interest ... something that requires more exploration in our cohort study and in others," he noted.

In addition to sex, those diagnosed prior to age 65 saw an average 8.2 years lost versus 1.8 years for those diagnosed later in life. Those who had diabetes for less than a decade saw 4.0 fewer years of life expectancy versus 4.9 years for those with a diabetes duration over 10 years.

Smoking was the most important factor that shortened lifespan for people with type 2 diabetes, with 10.2 years shaved off of life expectancy versus 2.7 years for non-smokers and 3.4 years for past smokers.

"The message is really clear: smoking is really bad for you if you have diabetes," Heald stressed.

For this analysis, Heald's group looked at data from 2010 to 2020 on people diagnosed with type 2 diabetes living in the Salford region of England. Actual death rates were compared with annual expected deaths calculated from the Office of National Statistics mortality rate.

A total of 11,335 individuals were included in the final analysis, including 5,540 new diabetes diagnoses and 3,921 deaths. Average age at type 2 diabetes diagnosis was 57.8, and average age at death was 78. The age-standardized mortality ratio was 1.84.

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