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Among the limitations of their study, the authors list the unavailability of German health data of sufficiently high quality (1). Indeed, the precise data sources for Germany remain largely unmentioned. The methods of the Global Burden of Disease (GBD) Study comprise the possibility to transfer data from other countries to Germany while considering national risk factors, which may lead to erroneous estimates.

For this reason, in a comparison calculation we estimated the years of life lost (YLL) due to diabetes on the basis of the KORA-S4/F4 study. KORA is a population based, prospective cohort study that includes undiagnosed diabetes in addition to patients with diagnosed type 2 diabetes (2).

When extrapolating the YLL which result from the KORA data for 2007 by means of an epidemiological model (3) to the age structure in Germany in 2010, the calculation shows 166 000 (95% CI 81 000–278 000) YLL due to diabetes for men and 137 000 (55 000 to 243 000) YLL for women. This tallies very well in the sex ratio as well as in the magnitude of the GBD estimates of 140 000 YLL and 110 000 YLL, respectively (1).

These data and the prognoses from (3) stress the enormous individual and societal burden of diabetes in Germany

DOI: 10.3238/arztebl.2015.0211a

Dr. rer. nat. Ralph Brinks

Annika Hoyer, MSc

Dr. med. Teresa Tamayo

Dr. rer. nat. Dr. rer. san. Bernd Kowall

PD Dr. med. Wolfgang Rathmann

Institut für Biometrie und Epidemiologie

Deutsches Diabetes-Zentrum, Düsseldorf

ralph.brinks@ddz.uni-duesseldorf.de

1.
Plass D, Vos T, Hornberg C, Scheidt-Nave C, Zeeb H, Krämer A: Trends in disease burden in Germany—results, implications and limitations of the Global Burden of Disease Study. Dtsch Arztebl Int 2014; 111: 629–38 VOLLTEXT
2.
Rathmann W, Strassburger K, Heier M, et al.: Incidence of Type 2 diabetes in the elderly German population and the effect of clinical and lifestyle risk factors: KORA S4/F4 cohort study. Diabet Med 2009; 26: 1212–9 CrossRef MEDLINE
3.
Waldeyer R, Brinks R, Rathmann W, Giani G, Icks A: Projection of the burden of type 2 diabetes mellitus in Germany: a demographic modelling approach to estimate the direct medical excess costs from 2010 to 2040. Diabet Med 2013; 30: 999–1008 CrossRef MEDLINE
1.Plass D, Vos T, Hornberg C, Scheidt-Nave C, Zeeb H, Krämer A: Trends in disease burden in Germany—results, implications and limitations of the Global Burden of Disease Study. Dtsch Arztebl Int 2014; 111: 629–38 VOLLTEXT
2.Rathmann W, Strassburger K, Heier M, et al.: Incidence of Type 2 diabetes in the elderly German population and the effect of clinical and lifestyle risk factors: KORA S4/F4 cohort study. Diabet Med 2009; 26: 1212–9 CrossRef MEDLINE
3.Waldeyer R, Brinks R, Rathmann W, Giani G, Icks A: Projection of the burden of type 2 diabetes mellitus in Germany: a demographic modelling approach to estimate the direct medical excess costs from 2010 to 2040. Diabet Med 2013; 30: 999–1008 CrossRef MEDLINE

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