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expert interviewed: fang hongjuan, director of the endocrinology department of the air force general hospital

global times health client reporter wang bingjie

after contracting diabetes, the body's higher-than-normal level of glucose "travels" throughout the body with the blood, which can be said to "hurt everything wherever it goes", leading to a variety of complications such as vascular disease, retinal disease, kidney disease and diabetic foot. in addition, a new study published by imperial college london found that diabetes can also "shorten life", shortening life expectancy by an average of 11 years.

after analyzing diabetes-related data from 46 million british adults, researchers found that diabetes can increase the risk of cancer,coronary heart disease, hypertension, copd andalzheimer's diseasethe onset of multiple chronic diseases such as diabetes and diabetes mellitus is advanced. the onset of women can be advanced by 20 years, and that of men by 15 years. by the age of 50, about 1/3 of diabetic patients may suffer from three chronic diseases at the same time and need to live with these diseases for more than 20 years; for every additional disease, life expectancy will be reduced by 4 years.

in terms of specific diseases, diabetes is complicated by cerebrovascular disease, coronary heart disease,heart failurechronic kidney disease usually occurs later in life, mostly in the 70s to 80s, and can shorten life expectancy by 4 to 6 years; chronic liver disease usually develops before the age of 70, and can result in a loss of up to 12 years of life; mental disorders such as depression, alcohol dependence andasthmathe age of onset is relatively early, but the impact of asthma on life expectancy loss is small.

the coexistence of multiple diseases varies in different age groups. among people over 70 years old, hypertension, coronary heart disease, osteoarthritis andatrial fibrillationthe prevalence of hypertension is high, and they are also prone to cancer, cerebrovascular disease, heart failure and chronic kidney disease, with a prevalence of between 12% and 20%. the situation is similar for people aged 50 to 69, but the overall risk of disease is reduced by 20% to 50%; among people aged 20 to 49, hypertension is still a common disease, but the incidence of depression, asthma and serious mental illness is higher.

fang hongjuan, director of the endocrinology department of the air force general hospital, told the global times health client reporter that if diabetes is not effectively controlled, it will often cause related lesions of blood vessels, nerves, kidneys, retina, etc., which will not only affect life expectancy, but also act as the "engine" of a variety of long-term chronic diseases.

obesity.diabetic patients are generally obese. high blood sugar and obesity together aggravate insulin resistance. long-term insulin resistance can cause excessive fat synthesis in the liver, leading to fatty liver, hepatitis and other problems. obesity is also often accompanied by high blood pressure, high blood lipids, and high uric acid, which can accelerate the occurrence or progression of kidney disease.

inflammatory response.diabetes is essentially an inflammatory disease that puts the body in a state of persistent chronic inflammation, which not only damages the health of blood vessels and organs, but may also cause impaired immune function, further increase the risk of infection, and aggravate the level of inflammation, thus forming a vicious circle.

intestinal flora disturbance.diabetic patients generally have intestinal flora imbalance, which is manifested by an increase in harmful bacteria and a decrease in beneficial bacteria. this imbalance not only aggravates the body's inflammatory response, affects blood sugar control, and thus aggravates insulin resistance, but is also closely related to the occurrence of gastrointestinal tumors. furthermore, it may affect cognitive function through the "brain-gut axis" and lead to the early onset of dementia.

malnutrition.many people over-control their diet for fear of its effect on blood sugar, which leads to malnutrition and increases the risk of calcium loss and osteoporosis. in addition, some diabetes treatment drugs can also affect the absorption of nutrients. for example, metformin may affect the gastrointestinal absorption of vitamin b12, thus causinganemia。

effects of medication.if a person suffers from multiple chronic diseases at the same time, the treatment drugs for different diseases may affect each other and even cause harm to the body. for example, glucocorticoids are the first-line medication for patients with copd, but they can cause insulin resistance, which in turn has an adverse effect on blood sugar control.

the study specifically pointed out that young people often lose more life expectancy after suffering from multiple chronic diseases. for example, if you suffer from three chronic diseases at the age of 40, your life expectancy may be shortened by about 14 years; if you delay the onset of the disease until the age of 60, the life expectancy loss may be reduced to about 8 years. in this regard, fang hongjuan said,type 2 diabetesfor every 10 years earlier the age of diagnosis, life expectancy will be shortened by about 3-4 years. the younger the age of onset, the longer the body will suffer damage. if you do not pay attention to disease control, have difficulty adjusting your lifestyle, or have risk factors such as obesity and "three highs", various injuries will continue to accumulate and become more obvious.

fang hongjuan emphasized that diabetes does pose a major risk to health, but it is essentially a "lifestyle disease." on the basis of standardized medication treatment, regular exercise (at least 150 minutes of moderate-intensity exercise per week); eating more coarse and less fine food, balanced nutrition, and ensuring high-quality protein intake can significantly reduce the damage caused by the disease. in clinical practice, many patients pay more attention to the development of the above habits after becoming ill, and become more "healthy". for example, bob krause from the united states suffered from diabetes at the age of 5 and died at the age of 91. his "sugar age" (diabetes history) was over 86 years. although studies have shown that diabetes may "short life by 11 years", individual differences are large, so there is no need to "force" it on yourself and become overly anxious about this data. ▲

editor: xu menglian

editor-in-chief: zhang mian