Juvenile Diabetes Life Expectancy

Having diabetes at a young and tender age can be very frustrating for anyone. Imagine depriving a child of all the candies his peers can freely eat or having to monitor them every now and then for an insulin shot. This and even more is the nightmare of many suffering from juvenile diabetes as well as their parents and/or guardians.

However, living a restricted lifestyle is the best way to manage and/or treat any kind of diabetes, this one included. If juvenile diabetes is left untreated, the consequences can be severe, life-threatening and fatal. Though this is a very difficult disease, some have successfully lived for long with it through proper nutrition management and a chance to do other lifestyle activities.

What is juvenile diabetes?

Juvenile diabetes also called type 1 diabetes is a disease in which the pancreas does not produce insulin or produces only a very small amount. This is because the immune system of those with juvenile diabetes destroys the beta cells of the pancreas, which are the cells that make insulin. Insulin is the hormone that helps our body cells take up sugar from the bloodstream. As such sugar levels in the blood remain high, which is dangerous for the entire body (1).

It is not the common type of diabetes that exist in the world today as only 10% of all diabetes is juvenile diabetes. About 422 million people worldwide have diabetes, and diabetes alone directly accounts for the deaths of about 1.5 million people every year (2). Though juvenile diabetes can affect people across different age groups, it earned the name juvenile diabetes because it's more prevalent in children and adolescents under 20 years of age (1).

Symptoms

The symptoms of juvenile diabetes are varied, and they include extreme thirst, dryness of the mouth, frequent urination, fatigue, increased hunger, blurry vision, stomach issues and vomiting, bedwetting for a child that normally does not, frequent infections of the skin, vagina or urinary tract, and unexpected weight loss though feeding well (3).

Emergency symptoms are rapid breathing, shaking and confusion, fruity-smelling breath, stomach pains and in rare cases, loss of consciousness (3).

The life expectancy of juvenile diabetes

Almost a century ago, it was almost impossible to live long with juvenile diabetes. As a matter of fact, it was a death sentence as the average person who developed juvenile diabetes died within two to five years. However, with the advance in medical research, insulin therapy was introduced in 1992, and the juvenile diabetes life expectancy has increased drastically (4).

Insulin therapy is administering insulin injections to diabetics to either supplement or replace the body’s own insulin. The aim is to achieve a normal or near-normal glucose level in the blood, thus preventing or diminishing the complications of high sugar levels in the blood and increasing the diabetic’s life expectancy (5). 

Several studies carried out over the recent decades have reported different improvements in the life expectancy of those with juvenile diabetes. The study carried out by Borch-Jassesn in 1992 reported 15 years increase in life expectancy (6). In the year 2000, the median life expectancy of those diagnosed with juvenile diabetes in the United States had increased to more than 15 years. This increase was the result of improved treatment that decreased predominantly the incidence of nephropathy, which is the decline in the functions of the kidneys (7).

Recent research studies carried out in Europe reported that the average person with juvenile diabetes will live about eight years less than their equals in the general population as of 2020 (8). In Sweden for example, those diagnosed with juvenile diabetes before 10 years of age had an estimated 16 years of loss of life than those diagnosed at higher ages. They were also reported to be 30 times more at risk of developing coronary heart disease as well as acute myocardial infarction, all of which increase mortality (9).

In the United States, juvenile diabetes life expectancy is estimated to be 11 years less compared to the general population. Generally, life expectancy will vary from person to person based on their nutrition and their ability to control their blood sugar levels (10).

What reduces juvenile life expectancy?

High blood sugar levels cause the blood vessels to narrow and get clogged, obstructing blood flow to many vital organs of the body. High blood sugar over time leads to diabetic kidney disease which is the primary cause of kidney failure in the United States (11). Diabetics who develop kidney failure are at a higher risk of death and have been reported to have about 16 years of life span loss (12).

It can also destroy the vagus nerves which is vital in moving food through the intestines. This can lead to weight loss which is deadly in the long run (3). Losing about 15% of body weight or more has been reported to reduce life expectancy as losing too much weight leads to gallstones, loss of muscle mass, electrolyte imbalances, and nutritional deficiencies all of which can pose a threat to one’s health and can prove fatal in a long run (13).

Moreover, high blood sugar levels can destroy the retina of the is a risk factor for coronary heart disease and stroke which are all life-threatening health conditions (14). Men who develop heart disease by the age of 50 years have an estimated seven-year life expectancy and women who develop heart disease at the same age have an estimated nine-year life expectancy. Generally, about 50% of those who have heart failure die within five years though whereas those with a more advanced condition have a life expectancy of one year (15).

Controlling one’s blood sugar levels can be very tough as insulin is a difficult drug to manage. Mismatching insulin intake and food intake can cause a dangerous drop in blood sugar levels, a condition called hypoglycemia. Hypoglycemia is characterized by symptoms such as rapid heartbeat, confusion, anxiety, and shakiness (4). 

Hypoglycemia can also cause the body to produce surplus blood acids (ketones) a condition called diabetic ketoacidosis. Diabetic ketoacidosis is life-threatening as it can cause swelling inside the brain, damage the kidneys and cause fluid to enter the lungs (16). Furthermore, hypoglycemia can lead to a diabetic coma and death. Diabetic coma has been estimated to account for 21% of deaths in people with juvenile diabetes though with related causes (17).

Diabetic ketoacidosis has been reported to increase mortality (about 40 deaths per 10,000 cases in males and 35 deaths per 10,000 cases in females). The deaths in juveniles aged 1 – 17 years old were at 1.8% and they also reported the highest admission and readmission incidence in the intensive care units in hospitals in the United States (18).

Predisposing factors

Since juvenile diabetes is an autoimmune disease, having a parent or both parents or sibling who has had juvenile diabetes predisposes a person to it as well. So, family history is the main risk factor. In the United States, Hispanics and African Americans are more likely to develop juvenile diabetes than White people. Also, exposure to some viral illnesses is said to play a role in the onset of juvenile diabetes (19).  

Treatment

Juvenile diabetes is a life-long disease, and its main treatment involves giving insulin for life. Insulin works well when given appropriately and it is the reason many have lived longer with any kind of diabetes. Insulin can be administered in a shut or via pumps, making it easier to deliver. Consequently, parents and guardians of children with juvenile diabetes can learn and be able to deliver insulin without much difficulty. Older parents can learn to give themselves shut down (4).

Better versions of insulin have been developed over the years which are also easier to use. Some work instantly and are vital for remedying crucial and emerging blood sugar level spikes. Rapid-acting insulin starts working after 15 minutes, peaks after 1 hour and lasts up to 4 hours. Regular or short-acting insulin starts working after 30 minutes, peaks between 1 to 3 hours, and lasts up to 6 hours (3).

Intermediate insulin starts working between 2 to 4 hours after being administered, peaks from 4 to 12 hours and lasts up to 12 to 16 hours. Long-acting insulin takes a couple of hours to start working and lasts about 24 hours (3).

Besides taking insulin, adhering to a healthy eating plan is also key to improving juvenile diabetes life expectancy. Healthy carbohydrates like whole grains are rich in fibre which controls blood sugar levels. Also, fruits and leafy vegetables are low in sugar contents, so they do not increase blood sugar rapidly. Besides they are a rich source of healthy minerals and vitamins (20)

The typical Western diet that consists of processed foods made with highly refined flours and loaded with added sugars and accompanied by sugary drinks is a no go for those with juvenile diabetes. Such fatty and sugary foods increase the risk of developing heart disease as they are loaded with cholesterol, and saturated and trans fats (3).  

Finally, exercising regularly plays a crucial role in extending the life expectancy of those with juvenile diabetes. Exercise increases insulin sensitivity which makes it easier to control blood sugar levels. Exercising requires less insulin to process carbohydrates. Exercising also helps to keep the body fit, increase energy levels, prevents weight gains, lowers blood pressure and the body maintains good cholesterol. Exercise is thus vital in preventing the development of arteriosclerosis which causes heart disease, and other complications that reduce the life expectancy of juvenile diabetes patients (21).

Juvenile diabetes is a rare form of diabetes that affects mostly children and adolescents less than 20 years of age. The earliest stage of detection usually ranges between the ages of 4 to 7, the next stage is at 10 years old and the later stages above 10 years. Though juvenile diabetes lasts for life, proper insulin therapy accompanied by a healthy eating plan and regular exercising has been proven to increase juvenile diabetes life expectancy.

Generally, men with juvenile diabetes have an estimated life expectancy of about approximately 66 years compared to their counterparts in the general population whose life expectancy of about 77 years. On the other hand, women with juvenile diabetes have an estimated life expectancy of 68 years, compared to their counterparts in the general population whose life expectancy is 81 years (22).

REFERENCES

1. CDC. (2022, March 15). What is type 1 diabetes? Retrieved May 9, 2022, from Centers for Disease Control and Prevention website: https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html
2. Keays, R. (2007). Diabetes. Current Anaesthesia and Critical Care, 18(2), 69–75. doi:10.1016/j.cacc.2007.03.007
3. Type 1 diabetes. (n.d.). Retrieved May 9, 2022, from WebMD website: https://www.webmd.com/diabetes/type-1-diabetes
4. LeWine, H. E. (2015, January 8). People with type 1 diabetes are living longer. Retrieved May 9, 2022, from Harvard Health website: https://www.health.harvard.edu/blog/people-type-1-diabetes-living-longer-201501087611
5. Janež, A., Guja, C., Mitrakou, A., Lalic, N., Tankova, T., Czupryniak, L., … Smircic-Duvnjak, L. (2020). Insulin therapy in adults with type 1 diabetes mellitus: A narrative review. Diabetes Therapy: Research, Treatment and Education of Diabetes and Related Disorders, 11(2), 387–409. doi:10.1007/s13300-019-00743-7
6. Borch-Johnsen, K. (1999). Improving prognosis of type 1 diabetes. Mortality, accidents, and impact on insurance. Diabetes Care, 22 Suppl 2, B1-3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10097891/
7. Narayan, K. M. V., Boyle, J. P., Thompson, T. J., Sorensen, S. W., & Williamson, D. F. (2003). Lifetime risk for diabetes mellitus in the United States. JAMA: The Journal of the American Medical Association, 290(14), 1884–1890. doi:10.1001/jama.290.14.1884
8. Campbell, P. (2020, September 23). Study estimates average life years lost from type 1, type 2 diabetes. Retrieved May 9, 2022, from Endocrinology Network website: https://www.endocrinologynetwork.com/view/average-life-years-lost-from-type-1-type-2-diabetes
9. Study finds childhood diabetes lowers lifespan by 18 years. (2018, August 13). Retrieved May 9, 2022, from GEN - Genetic Engineering and Biotechnology News website: https://www.genengnews.com/news/study-finds-childhood-diabetes-lowers-lifespan-by-18-years/
10. Type 1 diabetes. (n.d.-b). Retrieved May 9, 2022, from MedicineNet website: https://www.medicinenet.com/type_1_diabetes/article.htm
11. Diabetes and your eyes, heart, nerves, feet, and kidneys. (2014, December 8). Retrieved May 9, 2022, from National Kidney Foundation website: https://www.kidney.org/atoz/content/Diabetes-and-Your-Eyes-Heart-Nerves-Feet-and-Kidneys
12. Wen, C. P., Chang, C. H., Tsai, M. K., Lee, J. H., Lu, P. J., Tsai, S. P., … Wu, X. (2017). Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney International, 92(2), 388–396. doi:10.1016/j.kint.2017.01.030
13. Weight loss tied to all-cause mortality. (n.d.). Retrieved May 9, 2022, from Healio.com website: https://www.healio.com/news/endocrinology/20170828/weight-loss-tied-to-allcause-mortality
14. Long-term complications of diabetes. (n.d.). Retrieved May 9, 2022, from Medlineplus.gov website: https://medlineplus.gov/ency/patientinstructions/000327.htm
15. Crimmins, E. M., Hayward, M. D., Ueda, H., Saito, Y., & Kim, J. K. (2008). Life with and without heart disease among women and men over 50. Journal of Women & Aging, 20(1–2), 5–19. doi:10.1300/j074v20n01_02
16. CDC. (2021, April 2). Diabetic ketoacidosis. Retrieved May 9, 2022, from Centers for Disease Control and Prevention website: https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
17. Wise, J. (2015). Type 1 diabetes still shortens life span, Scottish study finds. BMJ (Clinical Research Ed.), 350(jan07 2), h59. doi:10.1136/bmj.h59
18. Ramphul, K., & Joynauth, J. (2020). An update on the incidence and burden of diabetic ketoacidosis in the U.s. Diabetes Care, 43(12), e196–e197. doi:10.2337/dc20-1258
19. CDC. (2022b, April 5). Diabetes risk factors. Retrieved May 9, 2022, from Centers for Disease Control and Prevention website: https://www.cdc.gov/diabetes/basics/risk-factors.html
20. Richards, L. (2020, August 5). Type 1 diabetes diet: Plans, meals, and healthy snack alternatives. Retrieved May 9, 2022, from Medicalnewstoday.com website: https://www.medicalnewstoday.com/articles/type-1-diabetes-diet
21. Daphne E. Smith-Marsh PharmD, C. D. E. (2009, August 26). Type 1 diabetes and exercise. Retrieved May 10, 2022, from EW website: https://www.endocrineweb.com/conditions/type-1-diabetes/type-1-diabetes-exercise
22. Type 1 diabetes linked to lower life expectancy. (n.d.). Retrieved May 10, 2022, from WebMD website: https://www.webmd.com/diabetes/news/20150106/type-1-diabetes-linked-to-lower-life-expectancy-in-study