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European Heart Journal Advance Access published online on December 24, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn567
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Development of life-expectancy tables for people with type 2 diabetes

Jose Leal1,*, Alastair M. Gray1 and Philip M. Clarke2

1 Health Economics Research Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
2 School of Public Health, University of Sydney, Sydney, Australia

Received 20 March 2008; revised 24 November 2008; accepted 27 November 2008.

* Corresponding author. Tel: +44 1865 289263, Fax: +44 1865 289271, Email: jose.leal{at}dphpc.ox.ac.uk

Aims: To develop tables that report the life expectancy associated with levels of major modifiable risk factors for patients with type 2 diabetes.

Methods and results: A set of tables reporting life-expectancy stratified by age–sex groups for combinations of modifiable risk was constructed based on predictions from the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model. This model is based on a system of parametric proportional hazards risk equations for estimating mortality and vascular complications of diabetes that have been estimated from 3642 patients from the UKPDS. The tables show substantial potential gains in life expectancy within every age group from modifying major risk factors. The estimated life expectancy of men at age of 55 years with type 2 diabetes, 5 years after diagnosis, varies between 13.2 years for a patient who smokes, has systolic blood pressure of 180 mmHg, a total:HDL cholesterol ratio of 8, and HbA1c of 10%, and 21.1 years for a non-smoker with SBP of 120 mmHg, total/HDL ratio of 4, and HbA1c of 6%.

Conclusion: Life expectancy tables provide a potentially useful tool of conveying prognostic information to people with type 2 diabetes and suggest substantial scope for increasing longevity by improving modifiable risk factors.

Key Words: Risk factors • Cardiovascular disease • Type 2 diabetes • Life expectancy • Mathematical modelling and simulation • Education


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