The Gothenburg Study

Hey guys, have you seen this? Seems to go in contrast to the more optimistic studies like the Pittsburgh study etc for life expectancy. Are there problems with this study and how does it stack up to the earlier studies that state the life expectancy of T1s is really only very slightly different from the general population, if you were born after 1965?

I couldn’t find when they conducted this survey of people. What were the years that the people had diabetes? Maybe it’s buried in the report, but I didn’t see it. I would like to have this information.

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agreed. It would certainly explain things if they are basing this on folks who were born in the 50’s or something when early control was terrible.

How could they tell if men died 14 years younger on average. That would mean they died in 2004 ish, and the average man lives to 77 years old, so that would make them 63 at the time of death…2004 minus 63 years old is 1941 birthdate.

That means many bad decades in the dark ages. Am I making sense?

EDIT: looks like they followed people from a registry for a 10 year period and looked at risk ratios…still unclear as to how that gives life expectancy accurate numbers

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Life expectancy of a woman in Sweden is 83 years.

Subtract 18 from that, get 65 years for the T1 women’s life expectancy.

BUT That is only for women diagnosed before the age of 10.

So they must have been diagnosed T1 55 or more years ago.

In the past 55 years there have been a lot of advances in diabetes treatment. I mean, really, when I was diagnosed 36 years ago it was urine testing only and basal+bolus was unheard of (although I was lucky was moved on to blood sugar testing quite quickly.)

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Bummer, I was born before 1965.

I ignore studies like this. They are meaningless when applied to a given person.

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Diagnosed in 1977. Told to expect that by 25 years I would be blind and missing one or more digits/limbs.

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The general statistic is that type 1 diabetics have a life expectancy 11 years shorter than the average. It has long been known that the earlier diabetes is diagnosed the worse it is, though the cut off point at which lifetime complications are worse turned out in previous studies to be around diagnosis before age 15. Interestingly, this is not because complications have begun earlier and so continued longer, since adolescents seem generally immune to clinically significant complications.

This study is not all that different from what was already known, since if generally type 1s are dying 11 years prematurely, then the special subset of those diagnosed very early dying 18 or 14 years too early if female or male, respectively, could fit into that earlier statistic, given the small numbers of those in that category.

It is certainly a statistically strong study, with more than 27,000 patients studied over a decade, which is a huge sample size.

I’d be curious about responses to this.

I know it is poor etiquette but this was on my mind tonight and I wasted a few hours thinking about this study.

As someone who was diagnosed at 10.5 years old in 1998, it gives me the heebie jeebies.

Reason being, they are saying that they looked at the risks for the earliest age of onset diabetics and said that if the risks follow this group throughout their lives, then they will be the worst off.

“Now there is robust evidence that survival largely depends on the age at which the patient develops the disease”

Wow, I wasn’t active on this board back when you posted this, so it is new to me. It really is a stunning result. I noticed that this paper has been cited in 88 subsequent papers, which is a sign that the paper has been well received and shouldn’t be dismissed.

I think this is like finding out too much about your personal genetic risk for something you can’t avoid. It is what it is, and there isn’t much we can do about it, other than the things we know we should do anyway. Namely, do our best to maintain a healthy A1c, eat healthy food (this implies Mediterranean based to me), and make sure to get plenty of exercise.

If anything this should serve as motivation for being as healthy as we can be.

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This doesn’t take into consideration the continued new developments and tech.
I was diagnosed in 1965 and should be dead by now if there weren’t huge changes in treatments, and expect even more to come.

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@Christoph
We already know Joslyn honored people that made it to 50 years as a diabetic because it was a rare event at one time. But look how many more people get a Joslyn medal now and it’s probably only a percentage that try to even get one. More people are living longer and all the new tech and knowledge has to have helped everyone’s chances.

I think a lot is not yet even known about how beneficial keeping numbers in better ranges can be. But we are seeing people already living longer.

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It also doesn’t account/adjust for:

-acute, early deaths due to ketoacidosis or lows, which would probably account for a good % of life lost, especially for children in that sub group

-those with kidney disease, which impacts heart health profoundly, and other studies show that in the absence of it the expectancy is similar to the general population

Also, they don’t speculate as to the reason for this difference in risk? Is it control during puberty? Is it longer amount of time with diabetes, and this might be able to be mitigated with good early control?

This study is more recent and with modern data:

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This is also fascinating and makes me want to protect my kidneys for long-term health above all else

Meaningless and mean :frowning:

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