Boehme Michael W J, Buechele Gisela, Frankenhauser-Mannuss Julia, Mueller Jana, Lump Dietlinde, Boehm Bernhard O, Rothenbacher Dietrich
State Health Office Baden-Wuerttemberg - Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart, Nordbahnhofstrasse 135, D-70191, Stuttgart, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstrasse 22, D-89081, Ulm, Germany.
BMC Public Health. 2015 Sep 3;15:855. doi: 10.1186/s12889-015-2188-1.
Type 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.
Lifetime 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.
The 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.
T2DM 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.
2型糖尿病（T2DM）已成为一种全球性流行病。这种慢性代谢疾病对预期寿命和生活质量有重大影响。该疾病的负担包括多种合并症。然而，德国西南部在很大程度上缺乏对患病率、发病率、相关疾病以及当前时间发展和地区差异的估计。
在2007年至2010年期间，对巴登-符腾堡州AOK（一家大型法定健康保险公司）所有参保人员的理赔数据集进行了基于终生诊断的患病率、发病率及伴随合并症的调查。分析基于相应的世界卫生组织国际疾病分类第十版（WHO-ICD-10）编码。数据针对德国西南部约1000万居民的常住人口按年龄和性别进行了标准化处理。
每年的总研究队列约涉及350万人。2007年至2010年，T2DM基于诊断的标准化患病率（SDP）从6.6%、7.4%、8.0%升至8.6%。在60至64岁年龄段，年度SDP在14.0%至18.9%之间，75岁及以上年龄段则在26.7%至31.8%之间。2010年，基于诊断的标准化患病率的地区分布分别在7.6%至11.6%之间。发病率在2008年为8.3、2009年为7.8、2010年为8.7（均为每1000人发病率）。2007年至2010年，T2DM的额外疾病风险（比值比）在肥胖方面为2.8至3.0，高血压方面为2.4至3.7，冠心病方面为1.8至1.9，中风方面为1.7至1.8，肾功能不全方面为2.8至3.4，视网膜病变方面为2.8至2.9。与非糖尿病人群相比，这些合并症出现得更早。
T2DM在德国西南部很常见且呈上升趋势。特别是在老年人群中，四分之一的人口受T2DM困扰。有趣的是，观察到了一种地区特异性模式以及早年生活中病例数的增加。我们的数据强调了开展糖尿病意识项目的必要性，包括早期诊断措施以及针对T2DM及其伴随合并症等主要疾病的结构化和及时的健康调查。
