German Prevention Act fails in primary prevention of type 2 diabetes
Background
Between 7 and 8 percent of the adult population in Germany has diabetes mellitus type 2 which results in an estimated total annual cost of € 35 billion for the healthcare system. To decrease the incidence, preventive measures are necessary. In 2015, the first German Prevention Act (PrävG) came into effect.The prevention of diabetes mellitus type 2 is mentioned as the first of eight health targets.
Objectives
The aim of this work is a constructive consideration to identify the primary preventive measures, since the PrävG came into effect. The focus of this research is on the environmental prevention.
Materials and methods
A systematic literature review was conducted using university databases, Medline, Web of Science and Google Scholar.
Results
Since the PrävG came into effect, no noteworthy measures considering the entire population have been initiated. Germany has no diabetes-related strategy, and a paradigm shift towards an environmental prevention has not taken place yet. Although medical societies have been advocating the implementation of environmental prevention measures for years, the legislature has so far refused to initiate normative measures. Furthermore, the evidence of such measures has been verifiable in other countries.
Conclusion
Behavioral preventive measures are not enough to decrease the incidence of diabetes mellitus type 2. There is a need for a paradigm shift, with a combination of behavioral and environmental prevention. Normative measures and a holistic approach with the integration of all stakeholders and their interdisciplinary responsibility is required to control the widespread disease of type 2 diabetes.