Prevalence, incidence and concomitant co-morbidities of type 2 diabetes mellitus in South Western Germany - a retrospective cohort and case control study in claims data of a large statutory health insurance

Abstract

BackgroundType 2 diabetes mellitus (T2DM) has become a world-wide epidemic. This chronic metabolic disease has a major impact on life expectancy and on quality of life. The burden of this disease includes a number of co-morbidities. However, estimates of prevalence, incidence and associated diseases as well as the current temporal development and regional differences are largely missing for South Western Germany.MethodsLifetime diagnosis-based prevalence, incidence and presence of concomitant co-morbidities were examined between the years 2007 and 2010 in the claims data set of all insured persons of the AOK Baden-Wuerttemberg, a large statutory health insurance. The analysis was based on the respective WHO-ICD-10 codes. Data were standardized for age and sex on the residential population of about 10 million inhabitants of South Western Germany.ResultsThe total study cohort involved approximately 3.5 million persons each year. The standardized diagnosis-based prevalence (SDP) of T2DM rose from 6.6 %, 7.4 %, 8.0 %, up to 8.6 % in the years 2007 to 2010. Yearly SDP was between 14.0 % and 18.9 % at an age range of 60 to 64 years and between 26.7 % and 31.8 % at an age of 75 years or older. In the year 2010 the regional distributions of standardized diagnosis-based prevalence were between 7.6 % and 11.6 %, respectively. Incidence rates were 8.3 in 2008, 7.8 in 2009, and 8.7 in 2010 (all rates per 1000). The excess disease risk (odds ratio) of T2DM was for adiposity 2.8 to 3.0, hypertension 2.4 to 3.7, coronary heart disease 1.8 to 1.9, stroke 1.7 to 1.8, renal insufficiency 2.8 to 3.4, and retinopathy 2.8 to 2.9 in the years 2007 to 2010. These co-morbidities appeared several years earlier compared to the non-diabetic population.ConclusionsT2DM is common and increasing in South Western Germany. In particular a quarter of the population in higher ages was afflicted by T2DM. Interestingly a region-specific pattern was observed as well as an increase in numbers during earlier years in life. Our data underline the need for diabetes awareness programmes including early diagnosis measures as well as structured and timely health surveys for major diseases such as T2DM and its concomitant co-morbidities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2188-1) contains supplementary material, which is available to authorized users.

Quantifying the potential for future gene therapy to lower lifetime risk of polygenic late-onset diseases

“…The Framingham General Cardiovascular Risk Score includes age as one of the major risk factors for stroke and CAD (D'Agostino Sr et al, 2008). (Boehme et al, 2015) show a similar pattern for T2D, and the results of this study are in agreement. The calculations applying the discovered aging coefficient to discrete hazard ratio values show a delay in onset incidence for all analyzed LODs.…”

“…Even though in this study each LOD is analyzed independently, in practice, prioritizing certain LODs for pre-ventative therapy could have a significant effect on other conditions not specifically targeted for treatment. For example, T2D is one of the diseases that cause the most co-morbidities, accelerating onset of cardiovascular and other diseases, sometimes by decades (Boehme et al, 2015). For this reason, preventative treatment of T2D could mean improvements in health or delays in the presentation of a range of LODs, either independently of or in addition to treating their specific gene variants.…”

“…Disease incidence data were obtained from the following sources: Alzheimer's disease (Brookmeyer et al, 1998;Edland et al, 2002;Kokmen et al, 1988;Hebert et al, 1995), type 2 diabetes (Boehme et al, 2015), coronary artery disease and cerebral stroke (Rothwell et al, 2005), and cancers (Cancer Statistics for the UK; . The simulations were performed on an Intel Xeon Gold 6154 CPU-based 36-core computer system with 288GB of RAM.…”

Evaluating the Potential of Younger Cases and Older Controls Cohorts to Improve Discovery Power in Genome-wide Association Studies of Late-onset Diseases

“…The population mortality statistics from the US Social Security Actuarial Life Table [59] provided yearly death probability and survivor numbers up to 119 years of age for both men and women. Disease incidence data from the following sources were extensively used for analysis, using the materials referenced in supplementary Chapter S1 in [36]: Alzheimer's disease: [11,[60][61][62]; type 2 diabetes: [63]; coronary artery disease and cerebral stroke: [64]; and cancers: [65,66].…”

Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom

“…Nevertheless, even in Western European countries, diabetes has become increasingly prevalent [1]. Studies have indicated an increase in prevalence from 2.39% in 2000 to 5.32% in 2013 in the United Kingdom (UK) [5], from 6.6% in 2007 to 8.6% in 2010 in southwestern Germany [6], and from 2.8% in 1990 to 4.6% in 2010 in Stockholm, Sweden [7]. In high-income countries, approximately 87–91% of diabetes patients have type 2 diabetes mellitus (T2DM) [3, 4], so the increases seen in the prevalence of diabetes are likely to be due to the increase in T2DM [1].…”