How Diabetes Affects Life Expectancy

If you’ve recently been diagnosed with diabetes, you may feel scared, confused, and lonely. You may be wondering how not only your quality of life will be affected, but perhaps you’re also worried about your life expectancy. 

Diabetes has historically caused people to have lower life expectancies, and that can be a scary truth to swallow for anyone living with the condition. 

This article will investigate the life expectancies for type 1 and type 2 diabetes, myths and truths around life expectancy and diabetes, and how you can help prevent diabetes complications, including premature death. 

What is a typical life expectancy? 

In short, there is no “typical” life expectancy. Life expectancy depends upon many factors, including: 

• year of birth
• gender
• family and health history
• genetics 
• home environment
• diet
• and even social determinants of health like your zip code at birth. 

These and many more factors can determine how long one might live. But that’s not the whole story! 

There are many other factors that determine how long someone will live, and there is no way to predict it: natural disasters, sudden diseases, or accidents can gravely cut someone’s life short. 

In the United States, the average life expectancy for adults was 78.86 years in 2019, about 5 years less than in our peer countries. 

Note: Life expectancy in the United States declined significantly in 2021 and 2022 due to the Covid-19 epidemic. 

Why can diabetes affect life expectancy? 

Unfortunately, diabetes touches nearly every part of your body: it affects your vision, heart, kidneys, brain, nerves, and blood vessels. 

If diabetes is not well-controlled, the damage to the nerves and blood vessels can lead to the development of comorbidities, such as heart disease, kidney disease, neuropathy, retinopathy, stroke, amputations, and even blindness, which can leave you disabled and shorten your life in a myriad of ways. 

This is because excess glucose in the bloodstream is very dangerous, and the longer you have diabetes, the more likely you are to suffer from diabetes complications caused by persistent or sustained hyperglycemia. 

Other, shorter-term complications can also lower life expectancy, such as a diabetic coma from a severe low blood sugar, and diabetic ketoacidosis, caused by extreme high blood sugar. Both of these conditions can be fatal. 

This does not have to be an eventuality, however. Well-managed diabetes does not necessarily lead to diabetes complications or comorbidities, and in some cases, hasn’t affected peoples’ life expectancies at all.

How much does diabetes lower life expectancy?

The short answer is that it doesn’t have to affect life expectancy at all. 

The longer answer is more nuanced, and since diabetes is so difficult to control, and there is no cure, it seems natural that near-constant high and low blood sugars would have some determination on life expectancy. 

In a groundbreaking 2010 research study by UK Diabetes, scientists discovered that the average life expectancy for someone living with type 2 diabetes is decreased by 10 years, and the average life expectancy for someone living with type 1 diabetes is decreased by nearly 20 years more than people without either condition. 

This, of course, sent shockwaves through the diabetes community. In a different study, released by the University of Pittsburgh in 2012, researchers found that people with type 1 diabetes diagnosed between 1965-1980 had a life expectancy of about 69 years (a longitudinal study of over 30 years). 

At the time of the study, that was only a mere 9 years shorter than the average US life expectancy overall. 

The cohort of people with diabetes diagnosed between 1965-1980 had a life expectancy about 15 years longer than people diagnosed with diabetes between 1950-1965. 

This study shows that improvements in insulin, medications, and diabetes technology is positively improving people’s life expectancies over time. 

Several other studies have shown shortened life expectancies for people living with diabetes, but years vary. 

A 2001 study found that people with type 1 diabetes lived an average of 59.7 years when diagnosed under age 30 and with the start of insulin treatment within 12 months of diagnosis. 

A 1999 study out of Denmark showed an increase in life expectancy of about 15 years over a 50-year period, following a type 1 diabetes cohort of patients. 

And the last time that life expectancy was specifically studied in people with type 1 diabetes in the United States was in 1975, where researchers found that people diagnosed with type 1 diabetes before 15 years of age had a life expectancy of about 27 years shorter than people without diabetes. 

This was, however, in the 1970s, and diabetes management and care have changed almost completely in the nearly 50 years since that study was conducted. 

More recent data, from a 2003 study of the National Health Interview Survey data from 1984-2000 shows that US children diagnosed with diabetes at 10 years old lose an average of 19 years of life. 

In a study out of Canada, the average life expectancy for people with diabetes was 13 years less than people without diabetes in Ontario (including both type 1 and type 2 diabetes in the data). 

More research is needed into life expectancy for people with type 1 and type 2 diabetes, but one thing is for certain: the better your diabetes management, the longer your life expectancy will be. 

Life expectancy for people with well-managed diabetes

We want to be clear, however, that just merely having a diagnosis of diabetes does not automatically lower your life expectancy! 

Many research studies do not control for things like diet, sleep, stress management, family history, and even things like terrible accidents, resulting in fatal high and low blood sugars that can alter results. 

Additionally, many statistics are based on averages, and often combine all types of diabetes into one data set (type 1, type 2, gestational, LADA, MODY, and more). 

If you have well-managed diabetes and your blood sugars and HbA1c are well within a healthy range (and this can only be determined between you and your doctor), then you should not worry about a shortened life expectancy. 

You are not a statistic! People with well-managed diabetes have been known to live full and complete lives, with normal life expectancies. 

Shortened life expectancies are a direct result of prolonged high blood sugars (sometimes acute low blood sugar episodes), and diabetes complications that develop into comorbidities that contribute to premature death. 

How can I increase my life expectancy? 

It’s not all doom and gloom, and people with diabetes are living longer than ever before. Most people, when they’re well-controlled, live to have a completely normal life expectancy. 

Some people are even thankful that they were diagnosed with diabetes, as it has made them be extra cognizant of their health, and adopt healthier habits as a result of their condition. 

Several other things you can do to help increase your life expectancy with diabetes include:

Maintaining tight blood sugar control and an HbA1c of under 7%. This is the American Diabetes Association’s recommendation. It will not only help prevent diabetes complications, but will also prevent premature death from those complications.

Increase your Time in Range (TiR). TiR is a relatively new term, but it’s used for people who use a continuous glucose monitor (CGM). 

It’s the percentage of the day that your blood sugar falls within a certain range (this is usually set by your doctor, but is usually between 70 mg/dL-180 mg/dL. The idea is that the higher the percentage, the fewer massive swings in blood sugar you’re having (and also the less time you’re spending either hyper- or hypoglycemic). 

Time in Range is sometimes seen as a more realistic glimpse into your overall control, as an HbA1c may merely be an average of a lot of really high and low blood sugar levels. 

See your doctor and/or Endocrinologist regularly. They can usually catch complications in the early stages (by checking your feet for sensitivity or your eyes for retinopathy, both of which can have few or no complications at the start). 

Regularly seeing your doctor can also make sure you’re calibrating your medications as needed, trying new medications as they come to market, and they can also check in with your mental health and get you more help if needed. 

Stay physically active and maintain a healthy weight. The Centers for Disease Control and Prevention (CDC) recommends exercising for 30 minutes per day, 5 days a week, for a total of 150 minutes per week (or more!). It’s important to incorporate moderate weight lifting a few times a week as well, to strengthen bones and keep muscles developed.

Eat a healthy, balanced diet. Limit processed foods and foods with added sugar. Eat plenty of fiber and lots of natural fruits, low-carb vegetables, and lean proteins. Work with a registered dietitian to formulate a healthy eating plan that will work for you and your lifestyle and goals. 

Don’t smoke! Smoking is the leading cause of preventable death in the world, and it’s even worse for people with diabetes, who are already at heightened risk for heart disease and stroke. Check out these free resources from the CDC on how to quit smoking. 

Maintain good blood pressure and cholesterol levels. People with diabetes are more likely to suffer from high cholesterol and blood pressure, putting us at even higher risk for heart disease and stroke, which shortens life expectancy. 

Ask your doctor about taking a statin if you’re over the age of 40, have diabetes, and are suffering from high cholesterol, and regularly check your blood pressure at home with a wrist cuff. 

Reduce your alcohol intake. Studies show that alcohol can contribute to the development of cancer, liver cirrhosis, and accidental injuries. It also prematurely ages the body, which can be especially difficult to handle if you already live with a chronic illness like diabetes. Limit your alcohol intake, and if you don’t currently drink, there’s little reason to start. 

Take all medications as prescribed! 

Find a treatment plan that works for you. Some people love their insulin pumps, others prefer pens. Some people love manually testing, some couldn’t live without their continuous glucose monitors (CGMs). 

The latest and greatest tech isn’t always the best thing, but if you’re curious about trying something new, go for it! You can always pivot and adapt if you don’t like something. Find a treatment plan and management style that will work for you in the long run, and make sure it’s something with which you can thrive. 

Seek support from family and friends, and create a community of people who you can be yourself around, and share your thoughts and feelings with. Living with diabetes is hard, but it’s easier when the load is shared with others who understand and love you. 

Conclusion

While historically, both type 1 and type 2 diabetes have been known to shorten life span, the data is sparse, and it varies on a case-by-case basis. 

What is known is that people having access to better insulins and newer technology has increased the lifespan of people with diabetes longer than ever before. Some people have even lived with diabetes for seven and eight decades! 

It’s important to know the risks of having a lifelong illness, but to not lose hope. 

There are many things you can do to extend your life expectancy, including tightly managing your blood sugar levels, aiming to keep a high time in range (TiR), eating a healthy diet and exercising, maintaining good blood pressure and cholesterol levels, seeing your doctor regularly, not smoking, and limiting your alcohol intake. 

Talk with your doctor about making any modifications to your health behaviors and/or insulin and diabetes medications before making any radical changes.