The St. Vincent Declaration, enacted in 1989, stipulated concrete goals for the improvement of diabetes care in Europe. The aim was to reduce relevant complications of diabetes mellitus – amputation, end-stage renal disease, blindness, myocardial infarction and stroke – by 30-50 %. Trend analyses from recent years indicated a positive development overall. The ISE has been carrying out continuous research to evaluate the St. Vincent goals since 2008.
The objective of the project is to estimate the incidence rates and relative risks of the following complications of diabetes in the population with compared to the population without:
Various data sources are consulted for the analyses: health insurance data (amputations, renal replacement therapy), dialysis centers (renal replacement therapy), Augsburg heart attack register, Erlangen stroke register, administrative files of the welfare administration (collection of newly approved blindness allowance recipients). The population with diabetes is estimated using population-based data (health insurance, health surveys). Incidence of the complications as well as the relative and attributable risks are estimated, comparing populations with and without diabetes. Time trends are analyzed using multivariate regression models.
Claessen H, Narres M, Haastert B, Arend W, Hoffmann F, Morbach S, Rümenapf G, Kvitkina T, Friedel H, Günster C, Schubert I, Ullrich W, Westerhoff B, Wilk A, Icks A. Lower-extremity amputations in people with and without diabetes in Germany, 2008–2012 - an analysis of more than 30 million inhabitants. Clinical Epidemiology 2018. doi: 10.2147/CLEP.S146484
Claessen H, Kvitkina T, Narres M, Trautner C, Zöllner I, Bertram B, Icks A. Markedly Decreasing Incidence of Blindness in People with and People without Diabetes in Southern Germany. Diabetes Care. 2018 Jan 9. pii: dc172031. doi: 10.2337/dc17-2031. [Epub ahead of print]. PMID: 29317450
Icks A, Claessen H, Kvitkina T, Narres M, Weingärtner M, Schwab S, Kolominsky-Rabas PL. Incidence and relative risk of stroke in the diabetic and the non-diabetic population between 1998 and 2014: A community-based stroke register. PLoS One. 2017 Nov 16; 12(11):e0188306. doi: 10.1371/journal.pone.0188306. eCollection 2017.
Claessen H, Genz J, Bertram B, Trautner C, Giani G, Zöllner I, Icks A. Evidence for a considerable decrease in total and cause-specific incidences of blindness in Germany. Eur J Epidemiol 2012; 27(7):519-24
Icks A, Haastert B, Genz J, Giani G, Hoffmann F, Trapp R, Koch M. Incidence of renal replacement therapy (RRT) in the diabetic compared to the non-diabetic population in a German region, 2002-2008. Nephrol Dial Transplant 2011 (Jan; 26(1): 264-9
Icks A, Scheer M, Genz J, Giani G, Glaeske G, Hoffmann F. Stroke in the diabetic and non-diabetic population in Germany. Relative and attributable risks, 2005-2007. J Diab Compl 2011 Mar-Apr; 25(2):90-6
Genz J, Scheer M, Trautner C, Zöllner I, Giani G, Icks A. Reduced incidence of blindness in relation to diabetes mellitus in southern Germany? Diabetic Medicine 2010 Oct; 27(10): 1138-43
Icks A, Dickhaus T, Hörmann A, Heier M, Giani G, Kuch B, Meisinger C. Differences in trends in estimated incidence of myocardial infarction in non-diabetic and diabetic people: Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) registry. Diabetologia 2009; 52: 1836-1841
Icks A, Haastert B, Trautner C, Giani G, Glaeske G, Hoffmann F. Incidence of lower-limb amputations in the diabetic compared to the non-diabetic population. Findings from nationwide insurance data, Germany, 2005-2007. Exp Clin Endocrinol Diabetes 2009; 117: 500-504