Association between regional deprivation and type 2 diabetes incidence in Germany

Objective The aim of this analysis was to estimate the association between regional deprivation and type 2 diabetes incidence and to investigate differences by age and sex for Germany.Research design and methods Type 2 diabetes incidence rate ratios comparing the most deprived fifth of the populatio...

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Main Authors: Ralph Brinks, Annika Hoyer, Wolfgang Rathmann, Esther Jacobs, Thaddäus Tönnies
Format: Article
Language:English
Published: BMJ Publishing Group 2019-05-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/7/1/e000857.full
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author Ralph Brinks
Annika Hoyer
Wolfgang Rathmann
Esther Jacobs
Thaddäus Tönnies
author_facet Ralph Brinks
Annika Hoyer
Wolfgang Rathmann
Esther Jacobs
Thaddäus Tönnies
author_sort Ralph Brinks
collection DOAJ
description Objective The aim of this analysis was to estimate the association between regional deprivation and type 2 diabetes incidence and to investigate differences by age and sex for Germany.Research design and methods Type 2 diabetes incidence rate ratios comparing the most deprived fifth of the population to the remainder of the population (divided into quintiles) were estimated using the illness-death model, which describes the relationship between prevalence, mortality, and incidence. For the analysis, we used the type 2 diabetes prevalence and the general mortality rate according to deprivation quintiles, which we calculated based on valid estimates for Germany. Because mortality rate ratios for people with type 2 diabetes compared with people without type 2 diabetes are lacking for Germany, we used estimates from Scotland. Estimates were standardized to the German population in 2012 and stratified by sex.Results Incidence of type 2 diabetes was estimated to be over twice as high among people living in the most deprived regions of Germany compared with people living in the least deprived regions (men: 2.41, 95% CI 1.27 to 4.28; women: 2.40, 95% CI 1.25 to 4.29). The strength of the association increased with increasing age until the age of 75 years. No sex differences were present.Conclusions The study adds new evidence regarding the association between type 2 diabetes incidence and regional deprivation for Germany. The results underpin the importance to intensify public health actions to reduce social inequalities in Germany and whole Europe in the future.
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spelling doaj-art-0063c56ba91c44f1b8bc0d7033817d8e2025-08-20T01:56:45ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972019-05-017110.1136/bmjdrc-2019-000857Association between regional deprivation and type 2 diabetes incidence in GermanyRalph Brinks0Annika Hoyer1Wolfgang Rathmann2Esther Jacobs3Thaddäus Tönnies4Policlinic and Hiller Research Unit of Rheumatology, UKD, Heinrich-Heine-University, Duesseldorf, GermanyDepartment of Statistics, Ludwig Maximilians University, Munich, GermanyGerman Center for Diabetes Research, Partner Düsseldorf, Neuherberg, Germany1 Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, GermanyInstitute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyObjective The aim of this analysis was to estimate the association between regional deprivation and type 2 diabetes incidence and to investigate differences by age and sex for Germany.Research design and methods Type 2 diabetes incidence rate ratios comparing the most deprived fifth of the population to the remainder of the population (divided into quintiles) were estimated using the illness-death model, which describes the relationship between prevalence, mortality, and incidence. For the analysis, we used the type 2 diabetes prevalence and the general mortality rate according to deprivation quintiles, which we calculated based on valid estimates for Germany. Because mortality rate ratios for people with type 2 diabetes compared with people without type 2 diabetes are lacking for Germany, we used estimates from Scotland. Estimates were standardized to the German population in 2012 and stratified by sex.Results Incidence of type 2 diabetes was estimated to be over twice as high among people living in the most deprived regions of Germany compared with people living in the least deprived regions (men: 2.41, 95% CI 1.27 to 4.28; women: 2.40, 95% CI 1.25 to 4.29). The strength of the association increased with increasing age until the age of 75 years. No sex differences were present.Conclusions The study adds new evidence regarding the association between type 2 diabetes incidence and regional deprivation for Germany. The results underpin the importance to intensify public health actions to reduce social inequalities in Germany and whole Europe in the future.https://drc.bmj.com/content/7/1/e000857.full
spellingShingle Ralph Brinks
Annika Hoyer
Wolfgang Rathmann
Esther Jacobs
Thaddäus Tönnies
Association between regional deprivation and type 2 diabetes incidence in Germany
BMJ Open Diabetes Research & Care
title Association between regional deprivation and type 2 diabetes incidence in Germany
title_full Association between regional deprivation and type 2 diabetes incidence in Germany
title_fullStr Association between regional deprivation and type 2 diabetes incidence in Germany
title_full_unstemmed Association between regional deprivation and type 2 diabetes incidence in Germany
title_short Association between regional deprivation and type 2 diabetes incidence in Germany
title_sort association between regional deprivation and type 2 diabetes incidence in germany
url https://drc.bmj.com/content/7/1/e000857.full
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