Dark shadow of diabetes casts even greater pall

Diabetes dramatically increases dementia, cancer risks, study finds

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Type 2 diabetes increases risk of other diseases not widely known to be linked.

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Australians with type 2 diabetes have a 60 per cent higher chance of developing dementia than those without the condition and are twice as likely to develop some types of cancer, according to a new report.

Dark shadow of type 2 diabetes, by the Baker Heart and Diabetes Institute, shines light on high-risk areas that are becoming increasingly recognised as complications of diabetes.

The latest national snapshot of type 2 diabetes shows a better approach is needed to address the wider health risks for the 1.5 million Australians with the disease, especially the growing number of those under 40 who may have had it for decades.

The report's lead author, Jonathan Shaw, said diabetes increased the risk of numerous other diseases that most people may not understand were linked.

"This is what we are calling 'the dark shadow of type 2 diabetes', as it can cast a much wider shadow than many realise," said Professor Shaw, head of clinical diabetes and population health at the institute.

A recent involving data from two million people showed those with type 2 diabetes had a 60 per cent greater risk of developing dementia compared to people without diabetes, with women more at risk than men.

Professor Shaw said people with type 2 diabetes were also more likely to develop many types of cancer.

"They are two to three times more likely to develop pancreatic cancer - one of the most deadly cancers - are twice as likely to develop liver or endometrial cancer, have a 50 per cent higher chance of getting bowel cancer and a 20 per cent greater risk of breast cancer," he said.

"Increased cancer risk is of particular concern for the growing number of people under 40 living with type 2 diabetes. This group saw a significant increase in deaths from cancer between 2000 and 2011."

On average, a 45-year-old with diabetes can expect to live six years less than a person free it.

Professor Shaw said many of these earlier deaths were due to heart disease, the biggest killer of people with type 2 diabetes.

"People with type 2 diabetes are up to eight times more likely to suffer from heart failure, compared to those without diabetes."

But he said the report also highlighted recent advances around the world showing that some of the newer diabetes medications had the potential to significantly reduce the number of people with diabetes who develop heart and kidney disease.

"It's vital that all those who could benefit from newer medications are receiving them whenever possible," he said.

"With the burden of diabetes complications in our community casting such a long shadow - in terms of death rates, disability and impact on the health system - we need greater education and support for those living with diabetes, as well as their GPs.

"In addition to controlling blood sugar levels, it is essential Australians living with type 2 diabetes are supported to keep blood pressure and cholesterol at healthy levels."

Other serious health implications outlined in the Dark shadow of type 2 diabetes:

  • The prevalence of non-alcoholic fatty-liver disease is very high among people with type 2 diabetes, and can ultimately lead to liver failure and the need for liver transplants.
  • Those with type 2 diabetes are 10 times more likely to develop kidney failure than those without the disease. For Indigenous Australians, diabetes is the primary cause of 70 per cent of all cases of kidney failure.
  • Amputations remain a major complication of type 2 diabetes.
  • Diabetic eye disease remains a leading cause of vision loss and blindness in working-age adults worldwide.
  • A wide range of other diseases and conditions are also more common in people with diabetes, including depression, osteoporosis, sleep apnoea, hearing impairment and gum disease.

Researchers at the institute are working to understand more about diabetes and how to prevent some of its devastating effects through large-scale research projects, including the PREDICT study.

baker.edu.au

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