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Type 2 diabetes: the costs of treating complications

Scientists at the Helmholtz Zentrum München have examined health insurance data of more than 300,000 people with diabetes in Germany. Their report, published in the medical journal ‘Diabetes Care’, breaks down the costs involved in treating various complications of the disease. The Helmholtz authors are members of the German Center for Diabetes Research (DZD).

It is estimated that around seven million people in Germany have type 2 diabetes. Even in its early stages, the disease can cause damage to blood vessels and other organs. This includes eye conditions that can lead to blindness, kidney damage that can result in renal failure, foot problems that may make amputation necessary and serious cardiovascular diseases including myocardial infarction or chronic heart failure.

“We wanted to know the extent of the associated costs that are borne by the statutory health insurance and thus by society as a whole,” says first author Katharina Kähm, summing up the aim of the study. The doctoral candidate and her colleagues from the Institute of Health Economics and Health Care Management (IGM) at the Helmholtz Zentrum München therefore examined the data of 316,220 people with type 2 diabetes from the years 2012 to 2015.

High health care costs associated with complications of type 2 diabetes
Based on this data, the researchers made a detailed assessment of the costs of diabetes-related complications. Since type 2 diabetes is most prevalent in older adults, they exemplarily calculated costs of a man between the ages of 60 and 69. In the quarter in which the respective complication occurred, costs were estimated as follows:

  • eye disease (retinopathy) approx. 700 euros
  • blindness approx. 3,000 euros
  • kidney damage approx. 3,400 euros
  • (dialysis-dependent) renal failure approx. 23,000 euros
  • diabetic foot approx. 1,300 euros
  • amputation approx. 14,000 euros


“Furthermore, the costs associated with cardio- and cerebrovascular disease range from 2,700 for angina pectoris to 20,000 euros for fatal ischemic heart disease,” adds Dr. Michael Laxy, who heads the working group at the IGM. “And in the quarters following the initial occurrence of these complications, the costs remain at a high level.”

The study is the first of its kind to be conducted on such a large scale and in such detail, the authors say. The long-term aim is to improve prevention programs: “The results show clinical and health policy decision makers the considerable financial consequences of diabetes-related complications,” says Prof. Rolf Holle. “The study can thus be helpful in the planning and prioritization of new prevention and treatment programs in the management of type 2 diabetes.” In the future, group leader Michael Laxy and his team aim to examine the economic impact of multiple co-existing diseases.