It is estimated that around seven million people in Germany have type 2 diabetes. Even in its early stages, the disease can cause damage to blood vessels and other organs. This includes eye conditions that can lead to blindness, kidney damage that can result in renal failure, foot problems that may make amputation necessary and serious cardiovascular diseases including myocardial infarction or chronic heart failure.
“We wanted to know the extent of the associated costs that are borne by the statutory health insurance and thus by society as a whole,” says first author Katharina Kähm, summing up the aim of the study. The doctoral candidate and her colleagues from the Institute of Health Economics and Health Care Management (IGM) at the Helmholtz Zentrum München therefore examined the data of 316,220 people with type 2 diabetes from the years 2012 to 2015.
High health care costs associated with complications of type 2 diabetes
Based on this data, the researchers made a detailed assessment of the costs of diabetes-related complications. Since type 2 diabetes is most prevalent in older adults, they exemplarily calculated costs of a man between the ages of 60 and 69. In the quarter in which the respective complication occurred, costs were estimated as follows:
• eye disease (retinopathy) approx. 700 euros
• blindness approx. 3,000 euros
• kidney damage approx. 3,400 euros
• (dialysis-dependent) renal failure approx. 23,000 euros
• diabetic foot approx. 1,300 euros
• amputation approx. 14,000 euros
“Furthermore, the costs associated with cardio- and cerebrovascular disease range from 2,700 for angina pectoris to 20,000 euros for fatal ischemic heart disease,” adds Dr. Michael Laxy, who heads the working group at the IGM. “And in the quarters following the initial occurrence of these complications, the costs remain at a high level.”
The study is the first of its kind to be conducted on such a large scale and in such detail, the authors say. The long-term aim is to improve prevention programs: “The results show clinical and health policy decision makers the considerable financial consequences of diabetes-related complications,” says Prof. Rolf Holle. “The study can thus be helpful in the planning and prioritization of new prevention and treatment programs in the management of type 2 diabetes.” In the future, group leader Michael Laxy and his team aim to examine the economic impact of multiple co-existing diseases.
Katharina Kähm is a participant in the Helmholtz Graduate School for Environmental Health, or HELENA for short. Her doctoral thesis is supervised by Prof. Rolf Holle, who has retired and whose working group is now being led by Dr. Michael Laxy.
Kähm, K. et al. (2018): Health Care Costs Associated With Incident Complications in Patients With Type 2 Diabetes in Germany. Diabetes Care, DOI: 10.2337/dc17-1763
The Helmholtz Zentrum München, the German Research Center for Environmental Health, pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München is headquartered in Neuherberg in the north of Munich and has about 2,300 staff members. It is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 37,000 staff members.
The Institute of Health Economics and Health Care Management (IGM) examines approaches to improving the effectiveness and efficiency of health care. The health care system faces the challenge of delivering high-quality, economically viable medical services to meet the needs of the population. Rapid advances in medical technology and fast-changing demographics further aggravate this problem. A firmly based evaluation of the effectiveness and efficiency of health care structures and processes is therefore an essential prerequisite for a rational health care policy.
The German Center for Diabetes Research (DZD) is a national association that brings together experts in the field of diabetes research and combines basic research, translational research, epidemiology and clinical applications. The aim is to develop novel strategies for personalized prevention and treatment of diabetes. Members are Helmholtz Zentrum München – German Research Center for Environmental Health, the German Diabetes Center in Düsseldorf, the German Institute of Human Nutrition in Potsdam-Rehbrücke, the Paul Langerhans Institute Dresden of the Helmholtz Zentrum München at the University Medical Center Carl Gustav Carus of the TU Dresden and the Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Zentrum München at the Eberhard-Karls-University of Tuebingen together with associated partners at the Universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich.
Contact for the media:
Department of Communication, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764 Neuherberg – Tel. +49 89 3187 2238 – E-mail:
Scientific contact at Helmholtz Zentrum München:
Katharina Kähm, Helmholtz Zentrum München – German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764 Neuherberg – Phone: +49 89 3187 4161 – E-mail: