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13 Sep 2022

Diabetes Age

Diabetes Age Hall: Olympia National Stand: G55

Diabetes Age is a new digital tool from Younger Lives to help people with type 2 diabetes understand how they can get their blood sugar under control and reverse its 'ageing effect' for life. 

Why do we say diabetes has an 'ageing' effect?

People with type 2 diabetes experience a shorter life expectancy than the rest of the population. If type 2 diabetes is left uncontrolled, excess glucose causes damage to the body, increasing the risk of complications at an earlier age. Lowering blood glucose levels reduces the risk of complications and the ageing effect. 

By calculating the impact of HbA1c on all cause mortality risk we can translate those risks into a risk based age as previously used in other approaches, such as 'Heart Age'. Research shows that patients understand and are motivated more by these communication methods than just explaining 'risk'

Diabetes Age has been designed to help explain and motivate people with type 2 diabetes on how the options (lifestyle and medication) available to reduce blood glucose can help you age more slowly as a result.

Motivating patients to change their future from the early stages

Phillips and colleagues (2014) in their article “We can change the natural history of type 2 diabetes” argued that we “waste the first ten years of the condition” and found that between 2003-6 and 2007-10 whilst there was a reduction in the proportion of patients with very high HbA1c* (>9%), the number of patients whose HbA1c was managed to under 7% was reduced. This suggests that whilst patients with failed glycemic control have been treated, early interventions to control HbA1c were not happening. This is particularly important given that spending more time with even small elevations in HbA1c has been shown to be associated with increased risk of complications and mortality (Laiteerapong et al., 2019) 

*HbA1c is a measure of your average blood glucose (sugar) levels over the last two to three months.

Providing evidence based feedback to patients

A number of trials in both individuals with prediabetes and diabetes have demonstrated the impact of weight loss, physical activity and glucose lowering drugs in controlling HbA1c. In the LookAHEAD trial (2016) the reduction in HbA1c amongst those who lost 10% of body weight was roughly 10% of the original HbA1c level and most of this was maintained amongst those who maintained their weight loss after 1 year. In a systematic review of metformin trials the reduction in HbA1c was 1.12% (Hirst et al., 2012). Until recently, management of HbA1c today was stratified according to current HbA1c level. For example, NICE guidelines recommended that when a patient’s HbA1c exceeded 7.0% that metformin should be initiated alongside the already initiated lifestyle changes to bring HbA1c to below 7 and other medications added if that proved insufficient. In the most recent guidelines, NICE now suggest that those at high risk should start with drug treatment immediately. Therefore,  understanding the benefits of well controlled diabetes is important to help patients make decisions about how they want to manage their condition.

How do we calculate the 'years off' achieved through lifestyle or medication

The Diabetes Age tool estimates the impact of weight loss & exercise and medication/tablets on HbA1c levels. Specifically, the amount of weight loss that is recommended is 10% of body weight maintained over years (for instance, for a patient weighing 90kg, this is equivalent to losing 9kg). We then model the impact of weight loss on HbA1c levels. To estimate the effect of medication the tool assumes standard treatment with metformin and model it's impact on the patient's HbA1c. We recognise that results for individuals will vary and some people may lose more or less weight or may be prescribed more intensive medication treatment by their doctor.

About Younger Lives 

Younger Lives Limited are trusted health & wellbeing behaviour change experts who believe that everyone has the ability to transform their lives with the right support. 

We are on a mission to help people live a lifestyle that is proven to control the rate of ageing, reduce the risk of long term health conditions - and most importantly, help people to feel their best and enjoy life whatever their age. Everything we do is based on proven health & behavioural science and uses 'people-centric' design to ensure we support the needs of real people. Our work delivers within clear impact frameworks and is based on proven science.

We are world leading experts in age-based risk assessments and programme design. Since creating the original heart age test back in 2007, we have gone from strength to strength, working with many private and public sector clients all over the world, implementing programmes in the UK, mainland Europe, the USA, Singapore and Abu Dhabi.  Our age-based assessment and programs include: Heart Age, Diabetes Age® and  Life Age® 

 

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