Long-term and recent trends in survival and life expectancy for people with type 1 diabetes in Finland

Abstract

Aims: Type 1 diabetes has been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have been associated with improved survival. However, life expectancy for type 1 diabetes under contemporary care is not known.

Methods: Health care registers were used to obtain data on all people with type 1 diabetes in Finland in 1964-2017 and their mortality in 1972-2017. Survival analyses were used to study long-term trends in survival and abridged period life table methods to calculate life expectancy estimates. Causes of death were examined to consider development.

Results: Study data included 42,936 persons with type 1 diabetes and 6,771 deaths. Kaplan-Meier curves showed improved survival during the study period. In 2017, the remaining life expectancy at the age of 20 for a person diagnosed for type 1 diabetes was estimated to be 51.64 (95% CI: 51.51, 51.78) years which was 9.88 (9.74, 10.01) years lower than for the general Finnish population.

Conclusions: We found improved survival among persons with type 1 diabetes during the last decades. However, their life expectancy remained significantly below that of the general Finnish population. Our results call for further innovations and improvements in diabetes care.

Keywords: Diabetes care; Epidemiology of diabetes; Life expectancy; Mortality; Survival; Type 1 diabetes.