Associations of Diabetes and Prediabetes with Mortality and Life Expectancy in China: A National Study
Objective
To investigate the excess mortality and life-years lost associated with diabetes and prediabetes in China.
Research Design and Methods
This national cohort study enrolled 135,405 participants aged 18 years or older from the general population in China. Cox proportional hazards regression models were used to estimate adjusted mortality rate ratio (RR). Life table method was used to estimate life expectancy.
Results
Among the 135,405 participants, 10.5% had diabetes and 36.2% had prediabetes in 2013. During a median follow-up of six years, 5517 deaths were recorded, including 1428 and 2300 deaths among people with diabetes and prediabetes, respectively. Diabetes and prediabetes were significantly associated with increased risk of all-cause (diabetes: RR, 1.61 [95% CI, 1.49-1.73]; prediabetes: RR, 1.08 [95% CI, 1.01-1.15), and cardiovascular disease (diabetes: RR, 1.59 [95% CI, 1.41-1.78]; prediabetes: RR, 1.10 [95% CI, 1.00-1.21) mortality. Additionally, diabetes was significantly associated with increased risks of mortality from cancer, respiratory disease, liver disease and diabetic ketoacidosis or coma. Compared to those with normoglycemia, people with diabetes and prediabetes lost on average 4.2 and 0.7 years of life at age 40, respectively. The magnitude of the associations of diabetes and prediabetes with all-cause and cardiovascular disease mortality varied by age and residence.
Conclusions
In this national study, diabetes and prediabetes were significantly associated with reduced life expectancy and increased all-cause and cause-specific mortality risks. The disparities in excess mortality associated with diabetes and prediabetes between different age and residence have implications for diabetes and prediabetes prevention and treatment programs.
