The Prevalence and Incidence of Diabetes in Germany: An Analysis of Statutory Health Insurance Data on 65 Million Individuals From the Years 2009 and 2010

The German Institute of Medical Documentation and Information (DIMDI, Deutsches Institut fur Medizinische Dokumentation und Information) was commissioned through the Data Transparency Regulation of 2012 to collect and process data from different areas of routine health care (1). This new data set provides comprehensive routine data from German statutory health insurance funds for the first time. In the case of type 2 diabetes it is known that the prevalence varies among policyholders from different insurance companies. The nationwide, population-based German National Health Interview and Examination Survey for Adults (DEGS1, Studie zur Gesundheit Erwachsener in Deutschland) of the Robert Koch-Institute (RKI) estimated the overall prevalence of type 2 diabetes in the whole population between 18 and 79 years of age at a total of 7.4%, made up of 9.0% for policyholders of the AOK (a large general statutory health insurance fund) and 7.0% for policyholders of substitute health insurance funds (2). Older population groups over 80 years of age and individuals who are in nursing homes or hospitals at the time of investigation, however, are underrepresented in epidemiological studies, with the result that projections for the total population are inaccurate. In fact, according to the census of 2011, around 4.2 million people in Germany were over 80 years of age (3). Routine data, therefore, often provide the only way of depicting the situation of older and hospitalized population groups. By including data from multiple insurance companies as well as in people over 80, the DIMDI data set closes an important data gap for Germany by facilitating more comprehensive estimates of the prevalence of type 2 diabetes. The prevalence of type 1 diabetes can also be determined on the basis of the data provided by DIMDI. Thus, this data set complements registry data from Baden–Wurttemberg, North Rhine–Westphalia and Saxony, which are limited to children and young adults (1, 4). The present study not only calculates the overall prevalence and incidence of diagnosed diabetes mellitus in Germany with a particular focus on type 2 diabetes, but also the age and sex specific prevalence and incidence including the age group of those over 80.