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Estimated Life Expectancy in a Scottish Cohort With Type 1 Diabetes, 2008-2010
Open accessAbstract
IMPORTANCE: Type 1 diabetes has historically been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have occurred in the past 3 decades. Contemporary estimates of the effect of type 1 diabetes on life expectancy are needed. OBJECTIVE: To examine current life expectancy in people with and without type 1 diabetes in Scotland. We also examined whether any loss of life expectancy in patients with type 1 diabetes is confined to those who develop kidney disease. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort of all individuals alive in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24,691 contributing 67,712 person-years and 1043 deaths). MAIN OUTCOMES AND MEASURES: Differences in life expectancy between those with and those without type 1 diabetes and the percentage of the difference due to various causes. RESULTS: Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women). CONCLUSIONS AND RELEVANCE: Estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy at age 20 years of approximately 11 years for men and 13 years for women compared with the general population without type 1 diabetes.
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“Cardiovascular disease remains the major cause of premature morbidity and mortality, with data119,120 suggesting an 8–13-year shorter life expectancy for people with type 1 diabetes than for healthy individuals.”
From Type 1 diabetes (2018) · cites this paper as [120]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Due in part to the success of modern diabetes management, people with type 1 diabetes are living longer, and the population of these people over 65 years of age is growing (121-123).”
From 13. Older Adults: Standards of Care in Diabetes—2024 (2024) · cites this paper as [121]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Due in part to the success of modern diabetes management, people with type 1 diabetes are living longer, and the population of these people over 65 years of age is growing (136-138).”
From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [136]
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In the citing paper
“In Scotland, mortality rates in 2008–2010 increased from 31.9 and 24.2 per 1,000 person-years in men and women, respectively, with T1DM who were aged 60–64 years to 142.7 in men and 171.3 in women aged ≥80 years39.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [39]
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In the citing paper
“In Scotland, reductions in life expectancy for people with T1DM aged 60–64 years were 5.6 years and 7.1 years for men and women, respectively39.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [39]
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“Due in part to the success of modern diabetes management, people with type 1 diabetes are living longer, and the population of people over 65 years with type 1 diabetes is growing (154–156).”
From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [154]
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Metadata
- Authors
- Livingstone, S. J., Levin, D., Looker, H. C., Lindsay, R. S., Wild, S. H., Joss, N., Leese, G., Leslie, P., McCrimmon, R. J., Metcalfe, W., McKnight, J. A., Morris, A. D., Pearson, D. W. M., Petrie, J. R., Philip, S., Sattar, N. A., Traynor, J. P., & Colhoun, H. M.
- Affiliations
- University of Dundee (GB)
- University of Glasgow (GB)
- University of Edinburgh (GB)
- Raigmore Hospital (GB)
- Borders General Hospital (GB)
- Scottish Renal Registry, Paisley, Scotland
- Western General Hospital (GB)
- NHS Grampian (GB)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2015-01-06
- Volume
- 313
- Issue
- 1
- Pages
- 37
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC4426486
- OpenAlex
- W1965748339
- Cited by
- 621
- References
- 19
- Citations by year
- 2026: 39 · 2025: 46 · 2024: 49 · 2023: 55 · 2022: 66 · 2021: 64 · 2020: 59 · 2019: 62 · 2018: 51 · 2017: 39 · 2016: 48 · 2015: 42
- FWCI
- 52.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- Funders
- Wellcome Trust (086113)
- Diabetes UK (10/0004010)
- Medical Research Council (MR/M501633/1, MR/K007017/1)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, life expectancy, life expectancy loss, kidney disease, estimated glomerular filtration rate, ischemic heart disease, diabetic ketoacidosis, diabetic coma, sex differences, causes of death, Scotland, life expectancy at age 65
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Diabetes Mellitus, Type 1, Diabetic Coma, Female, Humans, Life Expectancy, Male, Middle Aged, Prospective Studies, Scotland, Sex Factors, Myocardial Ischemia, Young Adult
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