New Issue of the Journal of Health Monitoring: status and perspectives of national diabetes surveillance at the RKI

Lothar H. Wieler, president of the Robert Koch Institute (RKI), points out that ‘Diabetes has become one of the world’s most common chronic diseases and is now in the focus of international action plans’. Furthermore, Wieler emphasises that ‘National diabetes surveillance provides an essential basis for sound policy decisions and for research and practice’. Type 1 diabetes usually develops in childhood. Type 2 diabetes is the dominant form of diabetes in adulthood. In addition to genetic factors, important risk factors for type 2 diabetes include older age, and health risks such as obesity, physical inactivity and smoking, all of which have a high prevention potential. In Germany, 9.2% of adults have diabetes (7.2% known diabetes and 2.0% unknown diabetes).

Data from the RKI’s health monitoring system show that the prevalence of diabetes is higher in the low education group than in the medium or high education group. Wieler stresses that ‘This poses a major challenge for health promotion and primary care’. The prevalence of unknown diabetes has decreased across all education groups, whereas the overall prevalence of diabetes has remained relatively constant. The RKI researchers see this as a possible indication of improved early detection.

To date, Germany has lacked standardised, comparable estimates of the prevalence and incidence of type 1 diabetes among adults, and overall estimates across all age groups. For type 1 diabetes, a recent estimate showed a total of about 341,000 adults in 2016. Type 2 diabetes is still a rare disease in children and adolescents in Germany with about 760 cases in 2016.

The RKI has also supported projects that evaluate the availability and suitability of data sources for surveillance. For example, trends in amputations were analysed using data from diagnosis-related groups statistics (DRG statistics). The observed decrease may be partly due to improvements in the care of diabetes patients. In 2016, almost 8,000 amputations due to diabetes were recorded in adults in Germany. Amputations of the lower extremity are considered potentially preventable because diabetes can be controlled well with adequate health care.

On the basis of data according to the Data Transparency Regulations, it was extrapolated that the number of people with diabetes will increase relatively by about 21% between 2015 and 2040 due to increasing life expectancy alone. When additional factors are taken into account, the estimates are even higher.

Further information is available at

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