Factors weighing in on long-term diabetes survival studied

(HealthDay)—Those able to survive with type 2 diabetes (T2DM) for more than 40 years are more likely to have better glycemic control, lower blood pressure, and more favorable lipid profiles, according to a study published online April 5 in Diabetes Care.

Viswanathan Mohan, M.D., Ph.D., from the Madras Diabetes Research Foundation in India, and colleagues retrospectively identified T2DM survivors (>40 years duration) from more than 200,000 case records. Survivors were matched to non-survivors based on age at diagnosis and sex. Retinal photography was used to diagnose retinopathy. Ankle-brachial index <0.9, vibration perception threshold >20 V were used to assess peripheral vascular disease and neuropathy.

The researchers found that mean duration of diabetes of survivors (n = 238) was 43.7 years and that of the non-survivors (n = 307), at time of death, was 22.4 years (P < 0.001). There was significantly higher systolic and diastolic blood pressures, plasma glucose, HbA1c, serum cholesterol, LDL cholesterol, triglycerides, and lower HDL cholesterol in non-survivors compared with long-term survivors. The most common causes of death were myocardial infarction (46.4 percent) and renal failure (16.6 percent). Survivors had a higher prevalence of most complications because of longer duration and older age, including: retinopathy, 76 percent in survivors versus 62 percent in non-survivors; microalbuminuria, 39.1 percent versus 27.3 percent; macroalbuminuria, 8.4 percent versus 23.7 percent; neuropathy, 86.5 percent versus 63.5 percent; peripheral vascular disease, 23.1 percent versus 11.4 percent; and coronary artery disease, 44.5 percent versus 40.7 percent.

"Long-term survivors with T2DM had better glycemic and blood pressure control and more favorable lipid profiles," the authors write.