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Global Prevalence of Diabetes: Estimates for the Year 2000 and Projections for 2030

Response to Wild et al.

From the Department of Biometrics and Epidemiology, German Diabetes Research Institute, Heinrich Heine University, Düsseldorf, Germany

Address correspondence to Dr. Wolfgang Rathmann, MD, MSPH, German Diabetes Research Institute, Auf’m Hennekamp 65, D-40225 Düsseldorf, Germany. E-mail: rathmann{at}ddfi.uni-duesseldorf.de

Global diabetes prevalence estimates for adults in 2000, which were derived from population-based data using oral glucose tolerance tests, were recently reported by Wild et al. (1). Because there are few OGTT-based data in the European region, estimates from a regional study carried out in the Netherlands were applied to 13 other countries, including Germany (2). For Germany, a prevalence of 4.1% was estimated, which corresponds to 2.6 million people with diabetes in 2000 (1).

In the German National Health Interview and Examination Survey in 1998, prevalence of known diabetes (self-reported) was assessed in a representative sample (aged 18–79 years) (3). Furthermore, from 1999 to 2001, glucose tolerance tests were carried out in the population-based KORA Survey 2000 (Augsburg, Germany) among 1,353 subjects aged 55–74 years (4). Both provided higher age- and sex-specific prevalence estimates than the Dutch study (2). Thus, 5% of the adult German population had known diabetes in 1998. In addition, at least in the age-group >55 years, one-half of the total cases were undiagnosed (4). The total diabetes prevalence (diagnosed and undetected cases) in the 55- to 74-year age-group was 16.6% in the KORA Survey (4). As the one-for-one ratio for known/undiagnosed case subjects is valid for all age-groups, the total diabetes prevalence in the adult German population in 2000 was 10%, corresponding to 6.3 million people. Germany should be listed among the 10 countries with the highest estimated number of people with diabetes in the world (1).

Thus, there is a greater diversity of diabetes prevalence in European countries than suggested by Wild et al. There are also differences in known risk factors for type 2 diabetes at the population level in European countries, e.g., the prevalence of obesity in Germany (20%) was almost twofold higher than in the Netherlands (5). Furthermore, the percentage of persons who did not partake in physical activity during their leisure time was higher in Germany (22.6%) than in the Netherlands (14.4%) and other European countries, which may partly explain the wide variation of diabetes prevalence (6).

References

1. Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care27:1047–1053, 2004[Abstract/Free Full Text]
   
2. Mooy JM, Grootenhuis PA, de Vries H, Valkenburg HA, Bouter LM, Kostense PJ, Heine RJ: Prevalence and determinants of glucose intolerance in a Dutch Caucasian population: the Hoorn Study. Diabetes Care 18:1270–1273, 1995[Abstract]
   
3. Thefeld W: Prevalence of diabetes mellitus in the adult population in Germany [in German]. Gesundheitswesen 61 (Suppl. 2):S85–S89, 1999
   
4. Rathmann W, Haastert B, Icks A, Löwel H, Meisinger C, Holle R, Giani G: High prevalence of undiagnosed diabetes mellitus in southern Germany: target populations for efficient screening: the KORA Survey 2000. Diabetologia46:182–189, 2003[Medline]
   
5. Seidell JC: Obesity in Europe: scaling an epidemic. Int J Obes Relat Metab Disord 19 (Suppl. 3):S1–S4, 1995
   
6. Varo JJ, Martinez-Gonzalez MA, Irala-Estevez J, Kearney J, Gibney M, Martinez JA: Distribution and determinants of sedentary lifestyles in the European Union. Int J Epidemiol 32:138–146, 2003[Abstract/Free Full Text]
   

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