Insulin is a hormone that is essential for managing blood sugar levels in people with diabetes. Without insulin, people with type 1 diabetes would not survive. However, with proper insulin therapy and diabetes management, people with diabetes can live long, healthy lives. In this article, we will explore how long a person can live relying solely on insulin therapy to control their diabetes.
What is Insulin?
Insulin is a hormone that is produced by the beta cells in the pancreas. It allows glucose from food to enter the body’s cells and be used for energy. Insulin is essential for:
- Allowing glucose to enter the cells
- Regulating carbohydrate, protein, and fat metabolism
- Promoting the storage of glucose in the liver and muscles as glycogen
- Inhibiting gluconeogenesis (the production of glucose by the liver)
- Inhibiting the breakdown of fat and protein
People with diabetes either do not produce insulin (type 1) or are resistant to its effects (type 2). As a result, they require insulin therapy to control their blood sugar levels. Insulin therapy aims to mimic the body’s normal physiological insulin secretion. Proper insulin dosing and timing helps keep blood glucose levels within a healthy range.
Types of Insulin
There are several types of insulin used to treat diabetes:
Rapid-Acting Insulin
- Starts working within 15 minutes
- Peaks in 60-90 minutes
- Lasts for 2-4 hours
- Names: Humalog, Novolog, Apidra
Short-Acting Insulin
- Starts working in 30-60 minutes
- Peaks in 2-3 hours
- Lasts for 3-6 hours
- Names: Regular insulin (Humulin R, Novolin R)
Intermediate-Acting Insulin
- Starts working in 1-2 hours
- Peaks in 4-10 hours
- Lasts for 10-16 hours
- Names: NPH (Humulin N, Novolin N)
Long-Acting Insulin
- Starts working in 1-2 hours
- Small peak in 6-14 hours
- Lasts for 20-24 hours
- Names: Lantus, Levemir, Tresiba, Basaglar
People with diabetes need a combination of different insulins to mimic normal insulin secretion. Short or rapid-acting insulin is used to handle increases in blood glucose from meals. Longer-acting insulin provides a background, basal coverage. An insulin regimen is tailored to the individual’s needs and lifestyle.
How Long Can You Live Without Insulin?
People with type 1 diabetes cannot survive without insulin therapy. Their bodies do not produce any insulin naturally. Without exogenous insulin administration, they will die.
This fact was tragically demonstrated in the early 20th century before insulin therapy was discovered. Children with type 1 diabetes frequently died within 1-2 years of diagnosis due to dangerously high blood sugars.
Once insulin was discovered and purified in 1921-1922 by Banting, Best, Collip, and Macleod, it completely transformed type 1 diabetes from a fatal disease to a manageable condition. People with type 1 diabetes could now inject supplemental insulin and live long, full lives.
So in summary, people with type 1 diabetes need lifelong insulin therapy to stay alive. They cannot survive more than a few days or weeks without insulin.
How Long Can You Live on Insulin?
With proper insulin therapy and diligent management, people with diabetes can live long, healthy lives, approaching the life expectancy of the general population.
Here is some data on life expectancy for people with diabetes:
- In one study, people with type 1 diabetes who were optimally managing their condition lived on average 66 years. This approached the 72 year life expectancy of the general population in that country.
- Another study found the life expectancy gap between people with type 1 diabetes and the general population has narrowed substantially in recent decades. By 2010, the difference was only about 6-8 years lower.
- People diagnosed with type 1 diabetes after 1965 who intensively manage their condition have nearly normal life expectancies today.
- With good control, people with type 1 diabetes have life expectancies in the late 60s on average. Some live into their 70s, 80s, and beyond.
So in general, with diligent disease management and insulin therapy, people with diabetes can expect to live long lives, many into old age. The life expectancy gap has narrowed dramatically over the past 50 years thanks to improvements in insulin preparations, glucose monitoring, patient education, and treatment.
Factors Affecting Life Expectancy
Several key factors affect life expectancy for people living with diabetes:
Glucose Control
Maintaining optimal blood sugar control is one of the most important determinants of long-term health and lifespan for diabetics. Consistently high blood glucose levels increase the risk of diabetes complications and premature death. Diligent monitoring, insulin therapy, diet, and lifestyle modifications to achieve good glycemic control are essential.
Management and Compliance
In addition to glucose control, following doctors’ recommendations including:
- Taking insulin properly and on schedule
- Checking blood glucose regularly
- Maintaining a healthy diet and exercise regimen
- Getting regular medical checkups
- Screening for and treating complications
Greatly improves long-term outcomes and longevity. Patient self-management education and compliance with treatment are key.
Access to Care
Having access to quality medical care and advanced diabetes treatments also influences life expectancy. Newer, fast-acting insulins, insulin pumps, and glucose monitors help patients achieve better control. Access to specialists like endocrinologists, diabetes educators, nutritionists, and ophthalmologists prevents and catches complications early.
Complications
Preventing and properly managing acute and chronic complications of diabetes is crucial for living long-term with the disease. Complications like diabetic ketoacidosis, kidney disease, cardiovascular disease, nerve damage, retinopathy, and infections shorten life expectancy. Diligent monitoring and proactive care to detect and treat complications prevents decline in health and lifespan.
Lifestyle Factors
General healthy lifestyle choices also impact longevity for diabetics. Not smoking, maintaining a healthy weight, controlling cholesterol and blood pressure, eating well, exercising regularly, limiting alcohol intake, and effectively managing stress are important. Good lifestyle habits reduce the complication risks from diabetes.
Can You Live a Normal Life Span on Insulin?
With dedicated disease management and access to quality care, many people with diabetes live long, full lives approaching normal life expectancies today.
While diabetes shortens average life expectancy by 5-10 years, this gap has narrowed dramatically in recent decades. Avoiding complications and achieving good control enables normal or near-normal life spans for many diabetics today.
Here are some examples of normal to near-normal life spans on insulin therapy:
- Former First Lady of Canada Jeanne Sauvé lived to age 62 with type 1 diabetes diagnosed in childhood.
- Jazz legend Ella Fitzgerald lived to age 79 after getting type 2 diabetes later in life.
- American tennis pro Arthur Ashe lived to 49 after developing diabetes-related complications.
- American musician Bret Michaels has had type 1 diabetes since age 6 and is now 59.
- Many people with childhood-onset diabetes now live into their 70s and beyond, approaching normal lifespans.
So while diabetes can reduce average expected lifespan, primarily due to complications, many people effectively manage their condition for decades and live well into old age thanks to insulin therapy and good healthcare.
Role of Insulin in Promoting Longevity
Insulin plays a crucial role in enabling people with diabetes to live long lives. Here are some of the key ways it promotes longevity:
- Survival – Exogenous insulin is literally life-saving for type 1 diabetics who cannot produce their own insulin.
- Blood Sugar Control – Insulin therapy helps keep blood glucose levels in a healthy range, preventing long-term complications.
- Energy Source – Insulin allows cells to access and utilize glucose, providing essential energy for the body and brain.
- Appetite Control – Insulin influences signals of hunger and satiety, important for maintaining proper nutrition.
- Protein Synthesis – Insulin promotes the synthesis of proteins that are vital structural and functional components of the body.
- Slowing Aging – Insulin and related growth factors play roles in slowing the aging process and promoting longevity at the cellular level.
In summary, insulin is absolutely essential for living with type 1 diabetes. When used properly, it can enable an otherwise normal or near-normal lifespan for many people with diabetes.
Famous People Who Lived Long Lives with Diabetes
| Person | Type of Diabetes | Lived to Age |
|---|---|---|
| Dr. James Best | Type 1 | 78 |
| Mary Tyler Moore | Type 1 | 80 |
| Ella Fitzgerald | Type 2 | 79 |
| Jay Cutler | Type 1 | Still living at age 39 |
| Nick Jonas | Type 1 | Still living at age 29 |
| Bret Michaels | Type 1 | Still living at age 59 |
These famous people with diabetes lived well into old age thanks to insulin therapy and diabetes care. Their longevity demonstrates that with dedication, diabetes can be managed for decades to enable normal or near-normal life expectancy.
Does Type 1 or Type 2 Diabetes Shorten Life More?
Both type 1 and type 2 diabetes can reduce average life expectancy. However, historically type 1 has had a greater impact.
Some key differences:
- Type 1 diabetes used to dramatically shorten lives prior to insulin availability. Many died within 1-2 years of diagnosis.
- Life expectancy loss in type 1 diabetes has improved more recently. The gap has declined from about 15 years to 6-8 years on average.
- Type 2 diabetes develops later in life. So even if lifespan is reduced, many still live into older age.
- Obesity and related complications play a bigger role in reduced longevity for type 2 diabetes.
- Overall health, access to care, and control play a large role in outcomes for both types.
In summary, while both types of diabetes can reduce lifespan, historically type 1 has had a greater impact. However, improvements in type 1 treatment and management have narrowed this gap substantially in recent decades.
Can People with Diabetes Live a Long Time Without Complications?
Yes, with tight blood sugar control and proper care, it is possible to live many decades with diabetes without developing serious complications.
Key factors that help prevent complications and promote longevity include:
- Maintaining HbA1c under 7% (or as close to normal as safely possible).
- Checking blood sugar 4-10 times daily and adjusting insulin accordingly.
- Following a low glycemic, high fiber, nutritious diet.
- Exercising regularly – ideally 30-60 minutes daily.
- Avoiding smoking and excess alcohol.
- Keeping cholesterol, triglycerides, and blood pressure optimized.
- Getting regular medical care from a diabetologist.
- Promptly treating any signs of complications.
The outcomes of the Diabetes Control and Complications Trial (DCCT) demonstrated that intensive control from a young age delays or prevents serious complications for decades.
With diligent management, diabetes complications can often be minimized or avoided for 20-30 years or longer after diagnosis. This allows people with diabetes to live out many decades of their natural lifespan in good health.
Life Expectancy for Type 1 Diabetes By Age of Onset
The age when someone develops type 1 diabetes also influences their potential lifespan.
- Diagnosis under age 10: Can still expect to live into late 60s or early 70s on average, with good control.
- Diagnosis in teenage years: Life expectancy can approach normal in this age group.
- Diagnosis after age 20: Much smaller reductions in life expectancy with proactive management.
In general, developing diabetes young poses greater risks to healthy lifespan. But modern treatments have narrowed the gap considerably for childhood-onset cases.
Teenagers and young adults diagnosed today can often manage diabetes for many decades without major impacts on lifespan. The earlier good control is established, the better the long-term outcomes.
Conclusion
In conclusion, the discovery of insulin made it possible for people with type 1 diabetes to live otherwise normal lifespans. Today, with diligent disease management and access to quality care, life expectancy approaches that of the general population for many diabetics.
While complications can still shorten lives, tight blood sugar control from an early age and proactive care to prevent and treat complications allows people with diabetes to live out many decades of life. The future is bright, as emerging treatments like closed loop pumps, refined insulins, and beta cell transplants promise to further improve health outcomes and longevity.