The association between smoking and the development of diabetes type 2 - results from the Germany burden of disease study
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Robert Koch Institute Germany
Germany Environment Agency
Koch Institute
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1953
To better plan public health interventions, information on which risk factors contribute most to the burden of disease is needed. The prevalence of diabetes type 2 (DT2) in Germany increased in the last years and causes a substantial disease burden. The aim of the study is to quantify the association between a set of risk factors (smoking, high body-mass index (BMI), diet low in fruits, risk alcohol consumption, high fasting plasma glucose and ambient particulate matter pollution) and the burden of DT2 in the German population.

To determine the risk-associated share of each risk factor on the burden of DT2, the population attributable fraction (PAF) is estimated using information on the relative risks and the distribution of the exposed population. The PAF is then applied to the total disease burden of TD2 to quantify the proportion of the TD2 burden that can be attributed to each single risk factor. To account for possible interactions of risk factors, a combined PAF for all risk factors is calculated using the multiplicative adjustment.

The preliminary results show that more than 50 % of the burden due to DT2 is attributable to avoidable risk factors. In the younger age groups this share is higher and in the older population significantly lower. The highest share of the attributable burden is assigned to high BMI, followed by high fasting plasma glucose and smoking. The affect of risk alcohol consumption shows somewhat controversial picture.

The results reveal that a substantially high share of the burden due to DT2 is caused by modifiable risk factors. Appropriate interventions are needed aiming at reducing the high BMI, smoking and high fasting plasma glucose in the population. Improving the air pollution and the diet habits of people would be positively reflected in the burden due to DT2.

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