Complications of diabetes: Systematic reviews

Diabetes is a common disease with significant consequences for patients and society. Patients with diabetes have a higher risk of amputations, end-stage renal disease, blindness, myocardial infarction and stroke compared to the population without diabetes. The incidence of these complications in people with diabetes has been frequently investigated. However, the studies differ considerably in terms of study design. A good overview of existing studies is still lacking.


Conducting systematic reviews with systematic search, evaluation, selection and synthesis of information from relevant population-based studies of retrospective and prospective design. The following questions are addressed:

  • Assessment of incidence (incidence rates, cumulative incidences) and trends in populations of people with diabetes and people without diabetes.
  • Analysis of the relative risk in the population with diabetes compared to the population without diabetes.
  • Study of regional differences and time trends

Project Lead and Contact Person


  • Dialyse-Zentrum Mettmann
  • Diabetic Foot Study Group (DFSG) of the European Association for the Study of Diabetes (EASD), Diabetesklinik Soest
  • International Workgroup on the Diabetic Foot (IWGDF), Belgien, Brüssel
  • Cochrane Metabolic and Endocrine Disorders Group, HHU Düsseldorf


  • Federal Ministry of Health (BMG)
  • Deutsche Diabetes-Stiftung


Systematic search, study selection and data synthesis according to PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Identification of relevant primary publications on incidence according to defined search terms in the relevant electronic databases. Studies are selected according to defined inclusion and exclusion criteria by two independent researchers (reviewers). Information is selected and documented in a standardized form.

Initially, systematic reviews on end-stage renal disease (ESRD) and lower-extremity amputations (LEA) were performed. Systematic reviews on stroke and myocardial infarction in the population with diabetes compared to the population without diabetes are currently being carried out.



Selected Publications

  1. Kvitkina T, Narres M, Claessen H, Droste S, Morbach S, Kuss O, Icks A. Incidence of lower extremity amputation in the diabetic compared to the non-diabetic population: a systematic review protocol. Systematic reviews. 2015;4(1):74. doi:10.1186/s13643-015-0064-9.
  2. Narres M, Claessen H, Droste S, Kvitkina T, Koch M, Kuss O, Icks A. The Incidence of End-Stage Renal Disease in the Diabetic (Compared to the Non-Diabetic) Population: A Systematic Review. PloS One. 2016;11(1): e0147329. doi:10.1371/journal.pone.0147329.
  3. Narres M, Kvitkina T, Claessen H, Droste S, Schuster B, Morbach S et al. Incidence of lower extremity amputations in the diabetic compared with the non-diabetic population: A systematic review. PloS One. 2017;12(8): e0182081. doi:10.1371/journal.pone.0182081.
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