Years of life lost (YLL)
Diabetes can lead to a loss of life years due to premature death. The number of years of life lost (YLL) in the population due to the cause of death diabetes allows conclusions to be drawn regarding the mortality-related contribution of diabetes to the entire burden of disease (disability-adjusted life years, DALY), and it is an important indicator for calculation and continuous monitoring of the cause-specific burden of disease.
- Diabetes was responsible for approximately 268,000 years of life lost due to mortality in 2017.
- Type 2 diabetes causes a relevant loss of life years especially at a high age; this is somewhat more pronounced in men than in women.
- Almost 92 % of the years of life lost due to diabetes are due to type 2 diabetes.
By education group
In 2017, approximately 267,600 life years were lost as a result of diabetes-related mortality. Men accounted for a somewhat larger fraction of the loss in life years with 56.2 % (men: 150,600 YLL; women: 117,100 YLL). 245,300 of the years of life lost due to diabetes (corresponding to 91.7 %) are related to diabetes mellitus type 2 and approximately 22,000 YLL to type 1 diabetes. Relating the YLL to the population, a total of 324.4 years per 100,000 persons in the general population were lost in 2017. Women lost 280.0 YLL whereas men lost 370.0 per 100,000 persons. Type 2 diabetes differs from type 1 in that more life years are lost in older age groups than in younger ones. Furthermore, there are differences between the federal states: Bremen shows the lowest value of 143.4 YLL per 100,000 persons and Saarland the highest value of 555.7 YLL.
Due to the large number of years of life lost, diabetes is one of the most important causes of death amongst non-communicable diseases (ranking tenth, Wengler et al. 2021a). There are strong regional differences, which, however, may be influenced by heterogeneous coding practice and quality (Wengler et al. 2019; Wengler et al. 2021b). Due to the demographic ageing of the German population, a further increase in the diabetes mortality is expected. Especially for type 2 diabetes, the diabetes-related mortality largely results from an accumulation of behaviour-related risks over the life-course. This underlines the need for adequate prevention offers commencing at younger ages.
Show more information on methodology and data sources
The indicator Years of life lost (YLL) is a measure of the mortality-related burden of disease due to diabetes. The number of years of life lost is calculated from the total sum of life years the deceased persons were expected to live on (if they had not died) according to their remaining life expectancy. The remaining life expectancy at the age of death corresponds to the (statistically expected) mean number of life years that remain at that age for the whole population (life table). This means that deaths at a younger age contribute more than deaths in the older age groups. For each age group, the highest remaining life expectancy measured in the sixteen federal states is used to determine the age-specific maximum that can be attained in Germany as an indicator.
Resident population in Germany.
Data are based on the national burden of disease study BURDEN 2020 – Burden of disease in Germany at the national and regional level (Rommel et al. 2018) – utilising the causes of death statistics for 2017 of the German Federal Statistical Office. For all approximately 932,000 deceased, information on the remaining life expectancy is complemented from the life tables (2016/2018) of the Federal Statistical Office.
The number of years of life lost due to diabetes is calculated by multiplying the sum of deaths due to diabetes in a certain age group by the remaining life expectancy of the respective age group (Murray et al. 2002; Rommel et al. 2018, Wengler et al. 2021a). These age-specific years of life lost are calculated separately by sex and federal state and can be added up into total values. The years of life lost are reported relative to 100,000 persons in the population.
The BURDEN 2020 study provides comprehensive results on the years of life lost in Germany based on the total number of deaths in the causes of death statistics. The quality of the data depends on the coding practice. For some deaths, the ICD code representing the underlying cause of death failed to be informative (invalid codes), these deaths were redistributed to informative ICD codes (Wengler et al. 2019; Wengler et al. 2021b).