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Disability-adjusted life years (DALY)
The contribution of death and disease to public health in a population is calculated based on summary measures. One frequently applied indicator of this type is called disability-adjusted life years (DALY) and is composed of the YLL and the YLD. While the former measures years of life lost due to death (YLL), the latter (YLD) indicates the years of life lost due to disability. Besides using DALY for the continuous monitoring of the overall burden of disease, another benefit of this indicator is the ability to reflect the relative contributions of death and disease to the overall burden of disease.
Key messages
- In 2017, the total burden of disease due to diabetes was 794,940 DALY, which translates to 961.7 DALY per 100,000 persons.
- The overall burden of disease due to diabetes increases with rising age and is higher in men than in women.
- While in type 1 diabetes more years of life are due to death (YLL), in type 2 diabetes the burden due to disability (YLD) predominates.
cross-section
By state
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By gender
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By age
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By education group
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Results
In 2017, the burden of disease due to diabetes mellitus was 794,940 DALY. This corresponds to 961.7 DALY per 100,000 persons, with men losing more (healthy) years of life than women (women: 896.9 DALY; men: 1028.4 DALY per 100,000 persons). An increase with rising age is evident: Whereas 106.6 DALY per 100,000 persons were calculated for the group of 30-39 years, the corresponding value in persons 80 years and older was 4,462.6 DALY. A comparison of YLL and YLD shows that two thirds (66.3%) of the burden of disease due to diabetes is attributable to YLD (YLD: 637.4; YLL: 324.4). While only 45.7% of the burden type 1 diabetes can be attributed to YLD, the proportion for type 2 diabetes is more than 20 percentage points higher at 67.4%.
Conclusion
The results indicate that men loose more (healthy) life years due to diabetes than women. Moreover, the figures confirm that steadily more (healthy) life years are lost with increasing age. However, the origin of the burden of disease varies: While in type 1 diabetes more years of life are due to death (YLL), in type 2 diabetes the burden due to disability (YLD) predominates. Accordingly, preventive measures should therefore be targeted more specifically at the drivers of the burden of disease. Likewise, the prevention of severe complications, for example through improved quality of care, may be useful to reduce the burden of disease due to diabetes in the population, especially in type 2 diabetes (Bundesärztekammer et al. 2021).