Towards NCD surveillance in Germany – diabetes as a paradigm

Background Non-communicable diseases (NCD) are a major public health challenge in Germany and throughout the world. The epidemiology of diabetes, in particular type 2 diabetes, exemplifies the need for effective prevention and control. To support policy making with actionable evidence, the Robert Koch Institute (RKI) is developing a diabetes surveillance system for Germany serving as model for NCD surveillance. Methods First, we consented a conceptual framework and key indicators among experts and stakeholders based on an extensive literature review including national and international NCD surveillance systems. After prioritization of indicators applying a two-step Delphi method, we identified data sources for sustainable surveillance including data from nationwide RKI health surveys as well as external data such as claims or registry data. Lastly, in cooperation with stakeholders we developed first dissemination products. Results During concept phase, we identified 40 indicators ranging from risk factors, disease incidence and prevalence to quality of care, mortality and burden of disease. During implementation, suitable data sources and results on temporal trends have been obtained for a large part of the indicators. For dissemination we developed a website with interactive visualization of results supported by an explainer video on YouTube. Additionally, we prepared a printed diabetes report summarizing and interpreting key findings for a broader audience, including health politicians and public health researchers. Conclusions We demonstrated the feasibility of the systematic collection and analysis of health data to describe the disease and care situation of diabetes in Germany. The methodology and data sources of indicators can be transferred to further NCDs and shared risk factors are already depicted. Next steps are to close remaining data gaps and to advance dissemination products in collaboration with our stakeholder network tailored to their information needs. Key messages Considering available health data, we showed the feasibility of implementing a diabetes surveillance system for Germany providing reliable information on disease dynamics for various stakeholders. The knowledge on methodology and data sources gained establishing a diabetes surveillance system can be extended to other noncommunicable diseases.