Decreases in Diabetes-Free Life Expectancy in the U.S. and the Role of Obesity

OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.