OBJECTIVES: The Global burden of disease study reported disability adjusted life year (DALY) on various causes including diabetes in the global, regional, and national levels. We aimed to estimate DALYs of type 2 diabetes reflecting diabetes related complications using Markov model at the national level.

METHODS: We used the National Health Insurance Service-National Sample Cohort and claim data between 2006 and 2016 to estimate DALYs reflecting diabetes and its complications for a lifetime. We developed a model with six Markov states including incident case, existing prevalent case, complication incident case, complication prevalent case, death caused by diabetes, and death caused by others. We assumed that diabetes and its complications would not be cured. The cycle was one year, and the simulation endpoint was 100 years old. Transition cases were counted by 5-year age groups above 30 years old. Age- and gender-specific transition probabilities were calculated based on its incident rate.

RESULTS: The total DALY due to diabetes was more than 2.3 million in 2016. YLD (Years lived with disability) and YLL (Years of life lost) was 1,891,706 and 492,496, respectively. Male and female in late 50s was found to be the most prominent subgroup for burden of diabetes in both male and female (22,761 vs. 185,911), followed by in the early 50s and the late 40s in men and in the early 60’s and the late 50s in women. YLL and YLD also showed similar trends with peaks in the 55-59 age groups. Trends of total DALYs due to diabetes was higher in male aged 30–64 years than in female, this tendency was reversed above the age of 65 years.

CONCLUSIONS: This study estimated DALY of diabetes and its complications using NHIS data 2006~2016. Markov model was useful to obtain the results considering relevant health states and integrate YLD and YLL in one approach.