Epidemiology of Diabetes Mellitus in German General Practitioners' Consultation - Results of the SESAM 2-study

 

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Abstract

The treatment of chronic diseases is of eminent importance in primary care, and type 2-diabetes mellitus is one of the most common dysfunctions. Its world-wide prevalence has been increasing from year to year. Thus, to estimate the prevalence and incidence of diabetes mellitus, we performed the SESAM (Sächsiche epidemiologische Studie in der Allgemeinmedizin) 2-study in cooperation with general practitioners (GPs) from the German state of Saxony; 270 of the 2510 (10.8%) solicited physicians participated. Cross-sectional data were collected from 1 October 1999 until 30 September 2000, from randomly selected patients previously known to the practitioner. From a total of 8877 consultations with 270 GPs, diabetes was prevalent in 14% (n=1241) of the patients and the incidence was 0.3% (27 of 8877 cases). The consultation prevalence was estimated at 14.3% (n=1268; CI 13.6-15%). Of the diabetic patients, 3.5% (n=44) suffered from type 1-diabetes, while type 2-diabetes was found in 66.9% (n=848) of the cases. “Other diabetes” was determined in 19.2% (n=244), and “not further specified diabetes”, in 10.4% (n=132) of the cases. Related to the German population in general, the prevalence ranged from 7.9 to 9.2%. The estimated consultation prevalence is about four times higher than that in other European countries. These data are of importance in illustrating the epidemiology of diabetes in the population and the direct repercussions for GPs. They also point out the significance of diabetes as a major challenge to the German health care system.

References

• 1 Altenhofen L, Haß W, Oliveira J, Brenner G. Modernes Diabetesmanagement in der ambulanten Versorgung. 1st edn. Cologne: Deutscher Ärzte-Verlag 2002
• 2 Cockburne J, Campbell E, Gordon JJ, Sanson-Fisher RW. Response bias in a study of general practice.  Fam Pract. 1988;  5 18-23
  CrossrefPubMedGoogle Scholar
• 3 Deckers J, Schellevies FG, Fleming DM. WHO diagnostic criteria as a validation tool for the diagnosis of diabetes mellitus: a study in five European countries.  Eur J Gen Pract. 2006;  12 108-113
  PubMedGoogle Scholar
• 4 Fleming DM, Schellevies FG, Casteren V van. The prevalence of known diabetes in eight European countries.  Eur J Public Health. 2004;  Mar14 10-14
  PubMedGoogle Scholar
• 5 Hauner H, Köster I, Schubert I. Prevalence of diabetes mellitus and quality of care in Hesse, Germany, 1998-2004.  Dtsch Arztebl. 2007;  104 2799-2805
  PubMedGoogle Scholar
• 6 Koch H, Graubner B, Brenner G. Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland. Erprobung der Diagnoseverschlüsselung mit der ICD-10 in der Praxis des niedergelassenen Arztes. Ergebnisse der wissenschaftlichen Begleituntersuchung zum Modellversuch in Niedersachsen und Sachsen-Anhalt im Jahre 1997. 1st edn. Cologne: Deutscher Ärzte-Verlag 1998
• 7 Michaelis D, Jutzi E, Heinke P. 30jähriger Inzidenz- und Prävalenztrend des juvenilen Typ-1-Diabetes in der ostdeutschen Bevölkerung.  Diabetes und Stoffwechsel. 1993;  2 245-250
  PubMedGoogle Scholar
• 8 Müller J. Beitrag zur Analyse der Allgemeinmedizin - Rostocker Studie. Berlin: Akademie für Ärztliche Fortbildung 1989
• 9 Palitzsch KD, Nusser J, Arndt H, Enger I, Zietz B. et al . Die Prävalenz des Diabetes mellitus wird in Deutschland deutlich unterschätzt - eine bundesweite epidemiologische Studie auf der Basis einer HbA1c-Analyse.  Diabetes und Stoffwechsel. 1999;  8 189-200
  PubMedGoogle Scholar
• 10 Schach E, Schwartz FW, Kerek-Bodden HE. Zentralinsitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland: Die EVaS-Studie - Eine Erhebung über die ambulante medizinische Versorgung in der Bundesrepublik Deutschland. 1st edn. Cologne: Deutscher Ärzte-Verlag 1989
• 11 Schiel R, Müller UA, Sprott H, Schmelzer A, Mertes B, Hunger-Dathe W, Ross IS. The JEVIN trial: A population-based survey on the quality of diabetes care in Germany: 1994/1995 compared to 1989/1990.  Diabetologia. 1997;  40 1350-1357
  CrossrefPubMedGoogle Scholar
• 12 Schulze J, Kunath H, Scholz G, Hanefeld M, Verlohren HJ, Otto H, Krumpolt C, Rothe U. Leitlinien Diabetes mellitus Typ 2. Dresden: Fachkommission Diabetes Sachsen 2001
• 13 Thefeld W. Die Prävalenz des Diabetes mellitus in der erwachsenen Bevölkerung Deutschlands.  Gesundheitswesen. 1999;  61 85-89
  PubMedGoogle Scholar
• 14 Wittchen HU, Krause P, Höfler M, Pfister H, Pittrow D. Die HYDRA-Studie - Bundesweite Studie “Hypertension and Diabetes Risk Screening and Awareness”.  Fortsch Med. 2003;  I 122 1-44
  PubMedGoogle Scholar
• 15 Zimmet P. The burden of type 2 diabetes: are we doing enough?.  Diabetes Metab. 2003;  29 6S9-618
  CrossrefPubMedGoogle Scholar

Correspondence

H. SandholzerMD 

Department of Primary Care of the Leipzig Medical School

Philip-Rosenthal Straße 55

04103 Leipzig

Germany

Phone: +49/341/971 57 10

Fax: +49/341/971 57 19

Email: sanh@medizin.uni-leipzig.de