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August 19, 2002

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Question from Woodstock, Illinois, USA:

Recently, an article was written in the Woodstock Independent published an article by Rich Rostron who was speaking to Michael Hunter. Michael is a pilot with diabetes who performs aerobatics to raise money for the American Diabetes Association. This article stated, "These children have a 30% chance of living to age 35." What is the current life expectancy averages for children with type 1 and also those with type 2 diabetes? Obviously closely monitoring your diet, exercise, and glucose levels affect the outcome greatly. I was just wondering what the averages are and how the author came to these figures.

Answer:

I don’t read the Woodstock Independent, but from what you say, the life expectancy figures sound quite unnecessarily defeatist, even discounting the need to embroider in order to fund raise. The problem with getting accurate ‘current’ figures is that the long term prognosis is constantly improving as new advances in management are adopted.

Of course, it makes a big difference whether you are a Caucasian domiciled in North America or Western Europe or someone living in a poverty-stricken third-world country. That aside, good control as determined by hemoglobin A1c tests is still the most important factor and in young adults these tests can now be in the normal range. Another aspect of this is the way early complications particularly of the microvasculature of the kidney and the retina can be detected and treated in the earliest stages. I refer to the measurement of microalbumin and treatment with ACE inhibitor drugs for early kidney complications and the use of retinal blood flow measurement, digital photography and treatment with PKC inhibitors for eye problems. Finally, the prospect that transplantation expectations will be greatly improved over the next decade by the development of greatly improved and shortened immunosuppressive regimens together with surrogate insulin producing cells I hope this makes you an optimist!

DOB