Article Text

Download PDFPDF

Perceived diabetes risk and related determinants in individuals with high actual diabetes risk: results from a nationwide population-based survey
  1. Christin Heidemann1,
  2. Rebecca Paprott1,
  3. Lena M Stühmann1,2,
  4. Jens Baumert1,
  5. Kristin Mühlenbruch3,
  6. Sylvia Hansen4,
  7. Catarina Schiborn3,
  8. Daniela Zahn4,
  9. Paul Gellert2,
  10. Christa Scheidt-Nave1
  1. 1Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
  2. 2Institute of Medical Sociology, Charité-Universitätsmedizin, Berlin, Germany
  3. 3Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  4. 4Office for National Education and Communication on Diabetes mellitus, Federal Centre for Health Education, Cologne, Germany
  1. Correspondence to Dr Christin Heidemann; HeidemannC{at}


Objective The purpose of this study was first, to examine perceived diabetes risk compared with actual diabetes risk in the general population and second, to investigate which factors determine whether persons at increased actual risk also perceive themselves at elevated risk.

Research design and methods The study comprised adults (aged 18–97 years) without known diabetes from a nationwide survey on diabetes-related knowledge and information needs in Germany in 2017. Actual diabetes risk was calculated by an established risk score estimating the 5-year probability of developing type 2 diabetes and was compared with perceived risk of getting diabetes over the next 5 years (response options: 'almost no risk', 'slight risk', 'moderate risk', 'high risk'; n = 2327). Among adults with an increased actual diabetes risk (n=639), determinants of perceived risk were investigated using multivariable logistic regression analysis.

Results Across groups with a 'low' (<2%), 'still low' (2% to<5%), 'elevated' (5% to <10%), and 'high' (≥10%) actual diabetes risk, a proportion of 89.0%, 84.5%, 79.3%, and 78.9%, respectively, perceived their diabetes risk as almost absent or slight. Among those with an increased (elevated/high) actual risk, independent determinants of an increased (moderate/high) perceived risk included younger age (OR 0.92 (95% CI 0.88 to 0.96) per year), family history of diabetes (2.10 (1.06–4.16)), and being informed about an increased diabetes risk by a physician (3.27 (1.51–7.07)), but none of further diabetes risk factors, healthcare behaviors or beliefs about diabetes.

Conclusions Across categories of actual diabetes risk, perceived diabetes risk was low, even if actual diabetes risk was high. For effective strategies of primary diabetes prevention, attention should be directed to risk communication at the population level as well as in primary care practice.

  • risk assessment
  • awareness
  • determinants
  • adult diabetes

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors CH, RP, LMS, DZ, PG and CS-N conceptualized the survey. CH defined the analytic strategy, analyzed the data and drafted the manuscript. RP and JB supported statistical modeling. All authors critically revised the manuscript for important intellectual content and read and approved the final version of the manuscript.

  • Funding The study “Disease knowledge and information needs - Diabetes mellitus (2017)” was funded by the Federal Ministry of Health (Funding Code: GE20160358).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the ethics committee of Berlin’s Chamber of Physicians (No: Eth-23/17) and the Federal Commissioner for Data Protection and Freedom of Information.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon reasonable request.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.