Abstract
BACKGROUND: In order to assess the prevention and care needs for type 2 diabetes in the coming decades from a public health perspective, forecasts on the trends in prevalence and case numbers are essential. METHODS: The data are based on age-specific estimates of diagnosed diabetes prevalence from the survey German Health Update (GEDA) 2022, and on the proportion of type 2 diabetes derived from routine health insurance data. Using routine data on the incidence and excess mortality of diabetes, various scenarios for the future trends of type 2 diabetes are modelled using an illness-death model. RESULTS: Based on a type 2 diabetes prevalence of 8.6 % in 2022 (women: 8.2 %, men: 9.2 %), corresponding to a total of 6.05 million cases (women: 2.92 million, men 3.13 million), the prevalence is expected to rise to 16.1 % by 2050 (women: 14.8 %, men: 17.4 %), with the number of cases increasing to 11.01 million (women: 5.19 million, men: 5.82 million). Assuming a 2.0 % annual decline in incidence, the prevalence is expected to rise to only 12.2 % (8.39 million cases); with a simultaneous 2.0 % annual decline in excess mortality, the prevalence is expected to reach 13.0 % (8.94 million cases). CONCLUSIONS: The prognosis is mainly influenced by changes in incidence. Primary preventive approaches to reduce risk factors for type 2 diabetes are therefore crucial to counteract an increase in the number of type 2 diabetes cases.