Tönnies T, Voeltz D, Voß S, Hoyer A, Brinks R
Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University, Düsseldorf, Germany.
Chair for Medical Biometry and Epidemiology, Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany.
Front Epidemiol. 2025 Feb 18;5:1388189. doi: 10.3389/fepid.2025.1388189. eCollection 2025.
Previous studies indicate that the prevalence of type 2 diabetes (T2D) will increase substantially over the coming decades. One projection from 2019 estimated an increase in prevalence in Germany by 54% to 77% (depending on future trends in incidence and mortality) between 2015 and 2040. We aim to update this projection by incorporating recently published trends in T2D incidence in Germany that include the changes during the SARS-CoV-2 pandemic.
We used a partial differential equation that describes the illness-death model to project the age- and sex-specific T2D prevalence among adults between 2015 and 2040. This required input data for the age- and sex-specific incidence, mortality of the general population, mortality rate ratio of people with vs. without T2D and prevalence in the initial year of the projection. We considered five scenarios with different future trends in incidence and their impact on prevalence. Using the most recently available data on T2D incidence, we assumed that the incidence remains constant as observed in 2021 for the whole projection horizon (first scenario). In further scenarios, we assumed that the observed age- and sex-specific trends in incidence between 2015 and 2021 would continue until 2025 (second scenario), 2030 (third scenario), 2035 (fourth scenario) and 2040 (fifth scenario). One additional scenario assumed that the age-specific prevalence remains constant.
Observed trends in incidence suggest a decrease between 2015 and 2017, and a slight upward trend thereafter until 2021 in most age groups. Depending on how long these observed increases in incidence continue, the number of people with T2D in Germany will increase from 6.8 million in 2015 to between 10.9 million and 14.2 million in 2040. These numbers correspond to increases in prevalence from 10.5% in 2015 to between 15.5% and 20.1% in 2040. In the constant prevalence scenario, the overall prevalence and number of people with T2D in 2040 was 11.4% and 8.1 million, respectively.
The future prevalence of T2D in Germany strongly depends on how long the recently observed increasing trend in T2D incidence will continue, which warrants close monitoring of these trends in post-pandemic years.
先前的研究表明，在未来几十年中，2型糖尿病（T2D）的患病率将大幅上升。2019年的一项预测估计，2015年至2040年间德国的患病率将上升54%至77%（具体取决于发病率和死亡率的未来趋势）。我们旨在通过纳入德国最近公布的T2D发病率趋势（包括新冠疫情期间的变化）来更新这一预测。
我们使用了一个描述疾病-死亡模型的偏微分方程，来预测2015年至2040年间成年人中按年龄和性别划分的T2D患病率。这需要年龄和性别特异性发病率、普通人群死亡率、T2D患者与非T2D患者的死亡率比值以及预测初始年份患病率的输入数据。我们考虑了发病率未来趋势不同的五种情景及其对患病率的影响。利用T2D发病率的最新可用数据，我们假设在整个预测期内发病率保持在2021年观察到的水平不变（第一种情景）。在其他情景中，我们假设2015年至2021年间观察到的年龄和性别特异性发病率趋势将持续到2025年（第二种情景）、2030年（第三种情景）、2035年（第四种情景）和2040年（第五种情景）。另一种情景假设年龄特异性患病率保持不变。
观察到的发病率趋势表明，2015年至2017年间有所下降，此后在大多数年龄组中直到2021年呈轻微上升趋势。根据这些观察到的发病率上升持续的时间，德国T2D患者数量将从2015年的680万增加到2040年的1090万至1420万之间。这些数字对应于患病率从2015年的10.5%上升到2040年的15.5%至20.1%之间。在患病率恒定的情景中，2040年T2D的总体患病率和患者数量分别为11.4%和810万。
德国T2D的未来患病率在很大程度上取决于最近观察到的T2D发病率上升趋势将持续多久，这需要在疫情后年份密切监测这些趋势。
