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By STEPHANIE NANO, Associated Press
      


NEW YORK (AP) - A 50-year-old person who has  diabetes dies six years
sooner than someone without the disease, and not just from a heart
attack or a stroke, new research suggests.

      The large international effort to measure diabetes' toll found
the disease also raises the risk of dying prematurely from a host
of other ailments, even breast cancer and pneumonia.

      "It's quite a wide sweep of conditions," said Dr. John Danesh
of Cambridge University in Britain, who led the team of
researchers. While most people think of heart problems, diabetes
surprisingly "appears to be associated with a much broader range
of health implications than previously suspected."
      


Putting the six years lost in context, he said, long-term
smoking shortens life by 10 years.
    


  The analysis used pooled medical information for 820,900 people
from nearly 100 studies done mostly in Europe and North America.
The results are published in Thursday's New England Journal of
Medicine.


      Diabetes, the seventh leading cause of death in the U.S.,
affects about 26 million Americans, or 8 percent, including 7
million who haven't been diagnosed. Most in the study were thought
to have the most common kind -- Type 2 -- which occurs when the body
makes too little insulin or cannot use what it does make to
regulate blood sugar.

      High blood sugar can damage nerves and blood vessels, and is a
major cause of heart disease.

      The new research didn't include those who had heart disease when
they were first enrolled. Participants were followed on average for
13½ years, and there more than 123,000 deaths. Overall, death rates
from various causes were higher for those with diabetes than those
without.

      The researchers took into account other risk factors that could
influence the results: age, gender, smoking and weight. Type 2
diabetes is tied to obesity. They found that those with diabetes
had double the risk of dying from a heart attack or stroke,
compared to those without the disorder. 

But they also found that
diabetics had a 25 percent higher risk of dying from cancer and
were more likely to die from a variety of illnesses including
infections, lung and kidney disease as well as falls.

      Exactly how diabetes raises those risks isn't clear, but in the
case of infections, it could be that diabetes weakens the immune
system, the researchers said. Diabetes can cause vision problems
and loss of feeling in the legs, which may be the reason for falls,
they said.

      Danesh said one intriguing finding was a higher risk of suicide
in those with diabetes. Other research has linked diabetes with
depression, he noted.

      The results are "another reason to try to normalize blood
glucose in people who have diabetes," through diet, exercise and
medication, said Dr. Alvin Powers, a diabetes specialist at
Vanderbilt University. "There have been smaller studies that
hinted at this, but nothing where a study of this size looked at so
many different outcomes."

      Danesh and his colleagues also estimated diabetes' effect on
life expectancy. They calculated that a 50-year-old diabetic
without heart disease dies about six years earlier than someone
without diabetes, with 40 percent of the difference due to
cancer and conditions other than heart disease.
     

 "It underscores the need to prevent diabetes," Danesh said.


      Previous studies have shown a possible link between diabetes and
cancer. The new paper tied some, but not all, cancers; the
increased risk ranged from 25 percent for breast cancer to double
for liver cancer. Danesh said people with diabetes should get
age-appropriate cancer screenings.
     


 Last year, a joint report from the American Diabetes Association
and the American Cancer Society looked at the issue and said that
it wasn't clear whether any connection was direct, indirect or
perhaps because the two disorders share common risk factors, like
obesity.
    

  The new research squares with that report's conclusion that
"there's a lot more we need to understand about diabetes and the
link to cancer," said one of the authors, Dr. Richard Bergenstal
of the International Diabetes Center at Park Nicollet in
Minneapolis. He a former president of the diabetes group.


      While adding to the evidence, the study doesn't answer the
question of why, he said.


      "Diabetes is a serious condition. We often don't think about it quite that way," Bergenstal said.

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A 50-year-old person who has  diabetes dies six years
sooner than someone without the disease, and not just from a heart
attack or a stroke, new research suggests.

Study links diabetes to earlier death from a range of health issues

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