ArticlePloS one2016
Quality of Diabetes Care in Germany Improved from 2000 to 2007 to 2014, but Improvements Diminished since 2007. Evidence from the Population-Based KORA Studies.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 63 citations in OpenAlex.
- Quality of Diabetes Care Among Older Adults in Germany-Results of the Study on Health of Older People 2022/2023 Compared With Previous National Health Surveys.Diabetes, obesity & metabolism · 2026Article
- Longitudinal study reveals plasma glycans associations with prediabetes/type 2 diabetes in KORA study.Cardiovascular diabetology · 2025Article
- Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries.Periodontology 2000 · 2025Review
- Respiratory rate and its associations with disease and lifestyle factors in the general population - results from the KORA-FF4 study.PloS one · 2025Article
- The mediatory role of androgens on sex differences in glucose homeostasis and incidence of type 2 diabetes: the KORA study.Cardiovascular diabetology · 2024Observational
- Association of plasma proteomics with mortality in individuals with and without type 2 diabetes: Results from two population-based KORA cohort studies.BMC medicine · 2024Article
- Differential association of dietary scores with the risk of type 2 diabetes by metabotype.European journal of nutrition · 2024Article
- Article
- Health and economic impact of improved glucose, blood pressure and lipid control among German adults with type 2 diabetes: a modelling study.Diabetologia · 2023Article
- Proteomic profiling of longitudinal changes in kidney function among middle-aged and older men and women: the KORA S4/F4/FF4 study.BMC medicine · 2023Article
- Trends of Antidiabetic and Cardiovascular Diseases Medication Prescriptions in Type 2 Diabetes between 2005 and 2017-A German Longitudinal Study Based on Claims Data.International journal of environmental research and public health · 2023Article
- Real-world demographic patterns of users of a digital primary prevention service for diabetes.Cardiovascular endocrinology & metabolism · 2023Article
- Scale-up of a chronic care model-based programme for type 2 diabetes in Belgium: a mixed-methods study.BMC health services research · 2023Article
- Long-Term Psychosocial Consequences of Whole-Body Magnetic Resonance Imaging and Reporting of Incidental Findings in a Population-Based Cohort Study.Diagnostics (Basel, Switzerland) · 2022Article
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- Article
- Cross-sectional and prospective relationships of endogenous progestogens and estrogens with glucose metabolism in men and women: a KORA F4/FF4 Study.BMJ open diabetes research & care · 2021Article
- Association of antecedent cardiovascular risk factor levels and trajectories with cardiovascular magnetic resonance-derived cardiac function and structure.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Article
- Article
- Status of Telemonitoring Services in Diabetes Care in Germany: A Narrative Review.Telemedicine reports · 2021Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLittle is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014.
methodsAnalyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999-2001, n = 150), F4 (2006-2008, n = 203), FF4 (2013/14, n = 212) cohort study. Information on patient self-management, physician-delivered care, medication, risk factor control and quality of life were assessed in standardized questionnaires and examinations. The 10-year coronary heart disease (CHD) risk was calculated using the UKPDS risk engine. Time trends were analyzed using multivariable linear and logistic regression models adjusted for age, sex, education, diabetes duration, and history of cardiovascular disease.
resultsFrom 2000 to 2014 the proportion of participants with type 2 diabetes receiving oral antidiabetic/cardio-protective medication and of those reaching treatment goals for glycemic control (HbA1c<7%, 60% to 71%, p = 0.09), blood pressure (<140/80 mmHg, 25% to 69%, p<0.001) and LDL cholesterol (<2.6 mmol/l, 13% to 27%, p<0.001) increased significantly. However, improvements were generally smaller from 2007 to 2014 than from 2000 to 2007. Modeled 10-year CHD risk decreased from 30% in 2000 to 24% in 2007 to 19% in 2014 (p<0.01). From 2007 to 2014, the prevalence of microvascular complications decreased and quality of life increased, but no improvements were observed for the majority of indicators of self-management.
conclusionDespite improvements, medication and risk factor control has remained suboptimal. The flattening of improvements and deteriorations in quality of (self-) care since 2007 indicate that more effort is needed to improve quality of care and patient self-management. Due to selection or lead time bias an overestimation of quality of care improvements cannot be ruled out.
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