The burden of diabetes-associated multiple long-term conditions on years of life spent and lost

Diabetes mellitus is a central driver of multiple long-term conditions (MLTCs), but population-based studies have not clearly characterized the burden across the life course. We estimated the age of onset, years of life spent and loss associated with diabetes-related MLTCs among 46 million English a...

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Published in:	Nature medicine Vol. 30; no. 10; pp. 2830 - 2837
Main Authors:	Gregg, Edward W., Pratt, Adrian, Owens, Alex, Barron, Emma, Dunbar-Rees, Rupert, Slade, Eirion T., Hafezparast, Nasrin, Bakhai, Chirag, Chappell, Paul, Cornelius, Victoria, Johnston, Desmond G., Mathews, Jacqueline, Pickles, Jason, Bragan Turner, Ellie, Wainman, Gary, Roberts, Kate, Khunti, Kamlesh, Valabhji, Jonathan
Format:	Journal Article
Language:	English
Published:	New York Nature Publishing Group US 01-08-2024 Nature Publishing Group
Subjects:	692/699/2743/137 692/699/2743/137/138 692/699/317 Adults Age Asthma Biomedical and Life Sciences Biomedicine Cancer Research Cardiovascular disease Cardiovascular diseases Coronary artery disease Dependence Diabetes Diabetes mellitus Drug dependence Heart diseases Hypertension Infectious Diseases Mental disorders Metabolic Diseases Molecular Medicine Morbidity Neurosciences Population studies
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Summary:	Diabetes mellitus is a central driver of multiple long-term conditions (MLTCs), but population-based studies have not clearly characterized the burden across the life course. We estimated the age of onset, years of life spent and loss associated with diabetes-related MLTCs among 46 million English adults. We found that morbidity patterns extend beyond classic diabetes complications and accelerate the onset of severe MLTCs by 20 years earlier in life in women and 15 years earlier in men. By the age of 50 years, one-third of those with diabetes have at least three conditions, spend >20 years with them and die 11 years earlier than the general population. Each additional condition at the age of 50 years is associated with four fewer years of life. Hypertension, depression, cancer and coronary heart disease contribute heavily to MLTCs in older age and create the greatest community-level burden on years spent (813 to 3,908 years per 1,000 individuals) and lost (900 to 1,417 years per 1,000 individuals). However, in younger adulthood, depression, severe mental illness, learning disabilities, alcohol dependence and asthma have larger roles, and when they occur, all except alcohol dependence were associated with long periods of life spent (11–14 years) and all except asthma associated with many years of life lost (11–15 years). These findings provide a baseline for population monitoring and underscore the need to prioritize effective prevention and management approaches. In a national study of 46 million adults, living with diabetes-related multiple long-term health conditions(MLTCS), particularly during young adulthood, led to extended periods of time with MLTCS, while also substantially reducing the years of life.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1078-8956 1546-170X 1546-170X
DOI:	10.1038/s41591-024-03123-2