Type 2 diabetes: prevalence and relevance of genetic and acquired factors for its prediction

Abstract

Background: The epidemiology of type 2 diabetes in Germany is of major societal interest, as is the question of the predictive value of genetic and acquired risk factors.

Methods: We present clinically relevant aspects of these topics on the basis of a selective review of pertinent literature retrieved by a PubMed search that centered on population-based studies.

Results: The German Health Interview and Examination Survey for Adults (Studie zur Gesundheit Erwachsener in Deutschland [DEGS1], 2008-2011) revealed that diabetes was diagnosed in 7.2% of the population aged 18 to 79 years (women 7.4%, men 7.0%). These figures are two percentage points higher than those found in the preceding national survey (1998). The percentage of cases that were not captured by these surveys is estimated at 2% to 7% depending on the method. Independently of personal factors (the individual's life style), it seems that living in a disadvantaged region characterized by high unemployment, air pollution, and poor infrastructure raises the risk of diabetes. Moreover, type 2 diabetes has a substantial hereditary component. More than 60 genetic regions have been identified to date that affect the risk of type 2 diabetes, yet all of them together account for only 10% to 15% of the genetic background of the disease.

Conclusion: The prevalence of type 2 diabetes in Germany has risen in recent years. The discovery of new genetic variants that confer a higher risk of developing the disease has improved our understanding of insulin secretion in diabetes pathogenesis rather than the prediction of individual diabetes risk ("personalized medicine").

Figure: Prevalence of diagnosed diabetes and regional deprivation in Germany.

a) Results of the DIAB-CORE Consortium of the BMBF Competence Network Diabetes Mellitus: prevalence of known type 2 diabetes in the 45- to 74-year-old age group. Data given as % (95% confidence interval). SHIP: Study of Health in Pomerania; CARLA: Cardiovascular Disease, Living, and Ageing in Halle Study; HNR: Heinz Nixdorf Recall Study; DO-GS: Dortmunder Gesundheitsstudie; KORA: Kooperative Gesundheitsforschung in der Region Augsburg b) GIMD (German Index of Multiple Deprivation, shown by administrative district [Kreis]). Maps produced by Werner Maier, Helmholtz Zentrum, Munich, based on VG250 (GK3), Federal Agency for Cartography and Geodesy. Reproduced by kind permission of Werner Maier, Munich