Patient Data Improves Life Expectancy Projections for Patients With Diabetes

Clinicians are now able to predict the 5- and 10-year life expectancy of older patients with diabetes using patient data, according to a new study published in Diabetes Care.

There are many factors that affect diabetes treatment, including co-occurring health conditions, complications due to diabetes, and heart failure. The benefits of low blood sugar can take years to manifest, and in older adults with a limited life expectancy, the burden of treatment may outweigh the benefits, according to the press release. Being able to predict life expectancy will help care providers decide which A1c target ranges are the best for each patient.

The study aimed to help inform the decision-making of doctors in setting glucose control targets. The electronic health records of more than 275,000 veterans with diabetes 65 years of age and older were used in the study.

According to the press release, researchers identified 37 predictive factors of life expectancy in older patients with diabetes. Among these factors were age, sex, marital status, blood pressure, body mass index, cholesterol and triglycerides levels, and prescriptions for insulin or sulfonylureas.

"But the guidelines don't give doctors guidance for how to decide whether or not people fall into these different bins for life expectancy…Furthermore, clinicians are notoriously inaccurate in predicting life expectancy, with studies frequently showing both over- and underestimating. We developed models with high predictive validity of future mortality in a large sample of older Veterans with diabetes," said Kevin Griffith of the VA Boston Healthcare System, which led the study, in the press release.

Researchers also noted that they aren’t saying any of these risks factors result in a decreased life expectancy, just that the more risk factors a patient has, the higher risk of mortality over time.

The study contained several limitations, such as an all-veteran cohort and older individuals. According to the press release, the results may not be generalized to other settings.

However, results can be used by other health care settings with similar records. Additionally, recent changes in the care of older individuals with diabetes, such as less emphasis on blood sugar control, could have affected the results of the model.

Reference

Patient data can predict life expectancy for older adults with diabetes (News Release); June 19, 2020; EurekAlert!; accessed June 22, 2020.