How Diabetes Affects Life Expectancy

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Lots of thoughts and questions go through your head after a diabetes diagnosis. Can you die from diabetes? Is diabetes life expectancy shorter? The answer to those questions and others about life expectancy depends on several different factors.

Types of Diabetes

Diabetes is the seventh leading cause of death in the United States. The type of diabetes you have can influence your life expectancy. Type 2 diabetes is the most common form of the disease and typically starts in adulthood. Having type 2 diabetes increases the risk of death 2- to 3-fold compared to not having it. On average, it decreases life expectancy by eight years.

Type 1 diabetes is less common. People usually develop type 1 diabetes in childhood or during teenage or early adult years. In the past, type 1 diabetes had a very high rate of early death. Improved treatment and monitoring has helped lower the risk of death significantly since 1965. However, the risk of death with type 1 diabetes remains higher than type 2 diabetes. Death rates from type 1 diabetes are up to 18 times higher than the general population.

Risk Factors and Diabetes Complications

The important thing to remember about life expectancy is that statistics and averages can’t tell you how long you will live. They are just guidelines and estimates. Each person with diabetes is unique. Your overall health and lifestyle can have dramatic effects on your longevity. This is true whether you have diabetes or not. But for someone with diabetes, it’s even more important to pay attention to health risk factors.

The following risk factors contribute to diabetes complications, which in turn have an effect on life expectancy:

  • High blood sugar levels: Uncontrolled high blood sugar gradually causes damage to body tissues. This leads to many diabetes complications, such as heart, kidney, eye and nerve damage. The longer blood sugar levels remain uncontrolled, the higher the risk of developing complications.

  • High blood pressure: It’s very common for people with diabetes to also have high blood pressure. Chronically elevated blood pressure causes damage to many of the same tissues as high blood sugar. It increases the risk of stroke, heart disease, kidney disease, and eye problems.

  • Lipid or cholesterol problems: People with diabetes often have low HDL or “good” cholesterol and high LDL or “bad cholesterol.” This further increases the risk of stroke and heart disease.

  • Obesity: Being overweight or obese is linked to insulin resistance, type 2 diabetes, and heart disease.

  • Smoking: People with diabetes who smoke double their risk of heart disease compared to people with diabetes who do not smoke.

Diabetes Complications and Life Expectancy

Some diabetes complications lead to disability and a poor quality of life. However, others are more closely related to life expectancy including:

  • Diabetic ketoacidosis (DKA): More likely with type 1 vs. type 2 diabetes, this complication occurs when insulin signals are very low and blood sugar levels are very high. The body rapidly starts breaking down fat, which generates a toxic level of ketones in the blood. DKA events are linked to a shorter life expectancy.

  • Heart disease: High blood sugar greatly increases the risk of heart disease. For adults with diabetes, heart disease is the main cause of death. This is true for both type 1 and type 2 diabetes. In total, at least 68% of diabetics 65 years or older will die from heart disease. This means older adults with diabetes are 2 to 4 times more likely to die from heart disease than those without the disease.

  • Kidney disease: High blood sugar damages the delicate tissues of the kidney. About 30% of diabetic adults have chronic kidney disease. When blood sugar remains uncontrolled, kidney disease can progress to end-stage renal disease (ESRD). This condition is a common non-heart-related cause of death for both types of diabetes.

  • Nerve damage: Uncontrolled blood sugar levels damage nerves also. This includes both peripheral nerves to the limbs and autonomic nerves. Autonomic nerves control organs, such as the heart, and functions, such as blood pressure. So autonomic nerve damage plays a role in both risk factors and complications that affect life expectancy.

  • Diabetic retinopathy: Vision loss is one of the most common complications of chronic diabetes-even among well-controlled diabetics. Small vessels that deliver fresh oxygen to the retina begin to leak fluid, resulting in diabetic macular edema. If these vessels stop working, abnormal new blood vessels emerge (neovascularization) and cause hemorrhage, membrane formation, and retinal detachment.

  • Stroke: People with diabetes have a higher than average risk of stroke. They are 1.5 times as likely to have a stroke as someone without diabetes. About 16% of diabetics will die from a stroke.

Taking Control

All of this information can be depressing, but there is good news. You can take control of your health and it’s never too late to start. As a diabetic, controlling your blood sugar levels is the single best thing you can do to protect your health and extend your life. The Centers for Disease Control and Prevention (CDC) also recommends the following healthy lifestyle habits:

  • Be physically active: You should aim for 30 minutes of moderate physical activity five days a week. This could include walking, biking or swimming.

  • Control your blood pressure: For most people, the goal is a blood pressure less than 120/80 mmHg. For people with diabetes, maintaining this goal can reduce the risk of heart disease by 50%. It can also reduce the risk of kidney disease and nerve damage by about 33%.

  • Follow a healthy eating plan: Work with your healthcare team to develop guidelines for healthy portions, eating out, and grocery shopping. They will help you learn how to use food labels, count carbs, and treat yourself too.

  • Get a regular A1c test: This test measures long-term blood sugar control. You usually need one every three months. The goal for most adults with diabetes is 7%.

  • Maintain a healthy body weight: Diabetics who are overweight can lower their risk of complication by losing just 5% of their body weight.

  • Manage cholesterol levels: Controlling cholesterol levels can reduce the risk of heart disease by 20 to 50%. This typically means a total cholesterol less than 200 mg/dL and an LDL level less than 100 mg/dL.

  • Stop smoking: Diabetics who smoke have more trouble controlling their blood sugar. Smoking also increases the risk of heart disease, stroke, and other complications. Quitting will give you better blood sugar control and lower your risk of death due to complications.

  • Take your medicines: This includes medicines for diabetes, heart disease, high blood pressure, and cholesterol. It’s important to take them exactly as your doctor prescribes. Talk with your doctor if you are having trouble taking your medicines or are struggling with side effects.

Diabetes is a lifelong condition. Burnout and fatigue are real issues for people dealing with the disease. But it’s vital to stay vigilant about your blood sugar control. If you are struggling in areas of healthy living, don’t let a setback discourage you. With support from your healthcare team, friends, and family, you can live in a way that adds years to your life.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 21
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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