Diabetes mellitus, particularly Type 2 diabetes, plays a significant role in the lives of many people. Approximately 537 million individuals – around 11% of the world’s population – live with this chronic condition. In Germany alone, around seven million people are affected. The disease drastically reduces quality of life and life expectancy, while the costs associated with its numerous complications, such as cardiovascular diseases and kidney damage, place a heavy burden on the German healthcare system.
Carolin Lehner and Dr. Gunther Schauberger, research associates at the Chair of Epidemiology led by Prof. Dr. Stefanie Klug, analyzed the incidence of Type 2 diabetes in Bavaria from 2012 to 2021 and examined the impact of the Covid-19 pandemic on new diagnoses. The Bavarian Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung Bayerns, KVB) provided the necessary health data. The study, titled “Incidence trend of type 2 diabetes from 2012 to 2021 in Germany: an analysis of health claims data of 11 million statutorily insured people”, was published in the journal “Diabetologia”, which has an impact factor of 8.4.
The study is part of a research project funded by the German Research Foundation (DFG) in collaboration with the Department of Health Economics. It is a secondary analysis based on health insurance data from the KVB, covering around 11 million insured individuals, representing approximately 85% of Bavaria’s total population. The study focuses on new diagnoses in individuals aged 20 and older. “Our primary goal was to examine the long-term incidence trend of Type 2 diabetes, as far less is known about incidence rates compared to prevalence,” explained Dr. Gunther Schauberger.
The anonymized data provide quarterly information during the defined period on gender, age, year of diagnosis, quarter of diagnosis, district, number of incident cases, at-risk population, and crude incidence rates. Using these data, age-standardized incidence rates (ASIR) and incidence rates within 10-year age groups were calculated. To assess the potential effect of the Covid-19 pandemic, a regression analysis was conducted.
In total, 745,861 new cases of Type 2 diabetes were diagnosed. The gender ratio was nearly balanced. During the study period, the median age at diagnosis decreased for both men and women. A general downward trend in the ASIR was observed, with a decrease of about 4.7% for both sexes. “The significant decline in incidence was somewhat unexpected, especially considering the older age groups,” Lehner stated, summarizing the key finding. “However, until now, there was simply a lack of data for such a comprehensive analysis over an extended period.”
This study is the first to publish a 10-year trend in Type 2 diabetes incidence in Germany, revealing a sharp decline between 2012 and 2017, followed by a more moderate decrease from 2018 to 2021. Despite rising prevalence, incidence rates declined. Possible explanations include changes in lifestyle factors and more thorough preventive screenings by general practitioners.
The Covid-19 pandemic did not have a significant impact on the findings. “This is the first time that robust longitudinal data on Type 2 diabetes incidence in Bavaria have been available. It is crucial to track these trends as there is no nationwide diabetes registry. Overall, there doesn’t appear to have been a lasting backlog in diabetes diagnoses during the Covid-19 pandemic,” explained Prof. Dr. Klug.
Looking ahead, Lehner expressed interest in future research: “It will be fascinating to see how the situation develops, for example, in four years. Will our results hold, or was this just a temporary, lower phase, and will the incidence rise again?” These questions form the basis for future research and highlight the need for continued analysis of data trends. “But simply having the ability to present reliable incidence rates for such a large population over a long period is invaluable,” Lehner concluded.
To the homepage of the Chair of Epidemiology
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Reply to Nilsson PM, Vaag A [letter]
Contact:
Prof. Dr. Stefanie Klug, MPH
Chair of Epidemiology
Georg-Brauchle-Ring 56
80992 München
Phone: 089 289 24950
E-Mail: sekretariat.klug.epidemiologie(at)mh.tum.de
Carolin Lehner
Chair of Epidemiology
Georg-Brauchle-Ring 56
80992 München
E-Mail: carolin.lehner(at)tum.de
Dr. rer. nat. Gunther Schauberger
Chair of Epidemiology
Georg-Brauchle-Ring 56
80992 München
Phone: 089 289 24955
E-Mail: gunther.schauberger(at)tum.de
Text: Bastian Daneyko
Photos: Pixabay/ Private