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Unlabelled: At present in Germany, data on the prevalence of diabetes can only be obtained by modelling health insurance data. The National Diabetes Register of the former (East) German Democratic Republic which, between 1960 and 1990, monitored approximately 98% of all diabetic subjects, provides a tool for evaluating epidemiological estimates from other data sources. Therefore, the following data bases were compared for the year 1988: (1) a 5% random-sample (n = 6478) of all subjects insured at a local statutory health insurance company in the city of Dormund; (2) related data from the population-based diabetes register of former East-Berlin and (3) of the former German Democratic Republic. All data were standardized by sex and age according to the 1988 population statistics of the Federal Republic of (West) Germany thus resulting in the apparent diabetes prevalence of the Western part of Germany at that time., Results: total prevalence rates were (1) 4.8%, (2) 4.9%, and (3) 4.4% (p < 0.05). The percentages of insulin-treated patients were (1) 18%, (2) 19%, and (3) 16%, respectively. 54% (1), 37% (p < 0.05) (2), and 42% (p < 0.05) (3), of the patients received oral antidiabetic drugs. It is concluded that the three samples are comparable and that the diabetes prevalence rates as estimated from health insurance data and from the two population-based registers give corresponding conclusions. Sample-based health insurance data may provide a useful and reliable tool for epidemiological studies on diabetes mellitus.

In order to investigate the possible influence of pre- and/or early postnatal nutrition on the development of diabetes mellitus in later life, diabetes prevalences were ascertained in subjects of similar ages who were born in different periods with or without shortage of food supply. Between 1974 and 1982 the total prevalence of diabetes mellitus increased in Berlin/GDR by 26%. A significantly higher increase of diabetes prevalence (approximately 90%) was found between 1974 and 1982 for subjects at 26-33 years of age, whose years of birth changed from a "hypocaloric war and post-war period (1941-1948)" to a "relatively hypercaloric peace period (1949-1956)". By contrast, there was not found any significant increase of diabetes prevalence between 1974 and 1982 for subjects at 34-41 years of age, whose years of birth changed from a "relatively hypercaloric period (1933-1940)" to a "hypocaloric period (1941-1948)". These findings give further evidence for the dependence of diabetes prevalence in later life on nutrition in perinatal life.

In view of experimental and clinical findings, it was predicted (Dörner, 1973 and 1976; Dörner and Mohnike, 1973 and 1977) that a preventive therapy of diabetes mellitus may be possible by preventing hyperinsulinism in perinatal life by means of prevention of hyperglycaemia in pregnant women and overnutrition in newborns. Meanwhile, this prediction appears to have been realized. Thus, the prevalences of diabetes mellitus in children, who were born in Berlin/GDR over the past decade, were found to be significantly decreased as compared to those born between 1962 and 1972. On the other hand, the children born in Berlin/GDR between 1962 and 1972 displayed a significantly higher prevalence of diabetes mellitus as compared to those born between 1957 and 1961. The decreasing prevalence of childhood-onset diabetes over the past decade has been apparently achieved by systematic prevention of hyperglycaemia and impaired glucose tolerance in pregnant women and overnutrition in newborns. These findings suggest that a preventive therapy of diabetes mellitus--even of insulin-dependent childhood-onset diabetes--is possible by preventing hyperinsulinism in the foetus and newborn during differentiation and maturation of the neuroendocrine central nervous-pancreatic system.