Decreases in diabetes-free life expectancy in the U.S. and the role of obesity.

Abstract

With increasing life expectancy in the U.S., it is important to know whether a longer life expectancy means a longer healthy life span or a prolonged period of later-life morbidity. This study examines changes in lifetime without diabetes, a leading cause of morbidity in later life. Using demographic methods and nationally representative data, we estimated changes in diabetes-free life expectancy between 1980-1989 and 2000-2004 for adult men and women in the U.S., estimated the contribution of changes in age-specific diabetes rates, and examined the changing effects of weight status on diabetes risks. While life expectancy at age 18 for men and women increased between the 1980s and the 2000s, diabetes-free life expectancy at age 18 decreased by 1.7 years for men and 1.5 years for women. The proportion of 18-year-olds who would develop diabetes in their lifetimes increased by almost 50% among women and almost doubled among men. Obese individuals experienced the greatest losses in diabetes-free life expectancy during this period, estimated at 5.6 years for men and 2.5 years for women. Diabetes-free life expectancy decreased for both men and women between 1980-1989 and 2000-2004, and these decreases are almost entirely attributable to large increases in diabetes incidence among obese individuals.