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We estimated the age of onset, years of life spent and loss associated with diabetes-related MLTCs among 46 million English adults. We found that morbidity patterns extend beyond classic diabetes complications and accelerate the onset of severe MLTCs by 20\u2009years earlier in life in women and 15 years earlier in men. By the age of 50\u2009years, one-third of those with diabetes have at least three conditions, spend &gt;20\u2009years with them and die 11\u2009years earlier than the general population. Each additional condition at the age of 50\u2009years is associated with four fewer years of life. Hypertension, depression, cancer and coronary heart disease contribute heavily to MLTCs in older age and create the greatest community-level burden on years spent (813 to 3,908 years per 1,000 individuals) and lost (900 to 1,417 years per 1,000 individuals). However, in younger adulthood, depression, severe mental illness, learning disabilities, alcohol dependence and asthma have larger roles, and when they occur, all except alcohol dependence were associated with long periods of life spent (11\u201314 years) and all except asthma associated with many years of life lost (11\u201315 years). These findings provide a baseline for population monitoring and underscore the need to prioritize effective prevention and management approaches.<\/jats:p>","DOI":"10.1038\/s41591-024-03123-2","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T06:06:46Z","timestamp":1722492406000},"page":"2830-2837","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["The burden of diabetes-associated multiple long-term conditions on years of life spent and lost"],"prefix":"10.1038","volume":"30","author":[{"given":"Edward W.","family":"Gregg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Owens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Barron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8532-7608","authenticated-orcid":false,"given":"Rupert","family":"Dunbar-Rees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirion T.","family":"Slade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Hafezparast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag","family":"Bakhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Chappell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Cornelius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-7108","authenticated-orcid":false,"given":"Desmond G.","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Mathews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Pickles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie","family":"Bragan Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Wainman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-4061","authenticated-orcid":false,"given":"Jonathan","family":"Valabhji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"3123_CR1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S2213-8587(13)70025-1","volume":"1","author":"HC Gerstein","year":"2013","unstructured":"Gerstein, H. 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K.K. is the National NIHR Applied Research Collaboration Lead for MLTC and Director of the NIHR Global Research Center for MLTC and is cochair of the MLTC Cross-NIHR Collaboration. N.H., E.T.S., E.B.T. and R.D.-R. are employed by OBH, which receives funding from NHS organizations (including NHS England) for providing analytical services. J.M. is the NIHR Clinical Research Network (CRN) Project Lead for MLTC and Head of Cluster A, NIHR CRN Coordinating Center. K.R. is the NIHR Clinical Research Network Project Manager for MLTC. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}