Trends in Mortality Rates in the Diabetic Population of the GDR^*)

Abstract

Based upon the National Diabetes Registry the mortality rates were assessed annually between 1961 and 1987 in the total diabetic population of the GDR. The rise of diabetes prevalence from 724/10(5) up to 3988/10(5) during the 27-year observation period was associated with an increase of relative mortality rates from 466% to 600% in insulin-treated diabetics, from 352% up to 528% in non-insulin-treated diabetics. By calculation of standardized mortality ratios (SMR) it could be shown that excess mortality is dependent on age but not at all on sex. Insulin-treated diabetics exhibited their maximum SMR of 650% to 750% at ages 25 to 45 years, while in non-insulin-treated diabetics the maximum SMR amounted to 450% at ages 25 to 35 years. In contrast to trends of the total relative mortality rates that of the overall age structure adjusted SMR of diabetics was characterized by a declining tendency, which may be a reflection of the improvement in diabetes care in our country, and which underscores the dependence of mortal, ty rates on the methods used for evaluation.

All-cause mortality in adults with and without type 2 diabetes: findings from the national health monitoring in Germany

“… 3 7 35 36 However, other meta-analyses contradict such sex differences 37 38 and SMR in the diabetes registry of the GDR in 1987 did not differ by sex. 11 More recently, analyses of excess mortality among US adults between 1997 and 2006 showed no relevant sex difference, 6 SMR for women and men in the Danish National Diabetes Register between 1995 and 2006 were almost identical, 5 and no interaction between T2D and sex was observed in mortality analyses of data from the Swedish National Diabetes Register. 4 …”

“…In Germany, standardized mortality ratios (SMR) comparing mortality among persons with diagnosed diabetes with mortality rates of the general population have been reported by the national diabetes registry of the former German Democratic Republic (GDR) amounting to 1.9 in 1961 and 1.7 in 1987. 11 More recent estimates are limited to point estimates from population-based cohort studies, including two regional cohort studies and one national cohort study. 12–14 While these studies were able to differentiate between persons with diagnosed and undiagnosed diabetes, results are inconsistent with regard to the extent of relative risk of death associated with diabetes and differences between persons with undiagnosed and diagnosed diabetes.…”

A systematic review of trends in all-cause mortality among people with diabetes

“…Of the 14 studies reporting age-specific mortality trends, six described trends in the period earlier than 2000 [6,19,[24][25][26][27] and no clear patterns of trends were observed during this period ( Table 3, Fig. 1 and 2).…”

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

“…Altogether, the prevalence of T2DM has risen considerably in Germany over the last decades. It was about 2 % in the year 1968 in Munich and 0.7 % in 1961 according to the former German Democratic Republic (GDR) diabetes register with an increase up to 4.0 % in the year 1987 [ 40 , 41 ]. The German National Health Interview and Examination Survey 1997/98 found a prevalence of known diabetes of 4.3 % for men and 3.8 % for women in the total population of Germany [ 42 ].…”