OBJECTIVES: While the independent influence of metabolic and cardiovascular diseases on either quality of life (QoL) or survival is well studied, the evidence on the combined burden in terms of quality adjusted life years (QALYs) is rather weak. Previous burden of disease studies mostly combined cross-sectional QoL data with mortality statistics from other data sources. However, due to strong model assumptions these studies might be limited in validity and accuracy. The goal of this study was to analyze the intermediate burden of diabetes in patients with previous myocardial infarction in terms of QALYs lost, by introducing a method capable to exploit primary longitudinal data sources of population-based studies. METHODS: Data for this analysis were taken from the KORA-Acute Myocardial Infarction (AMI) Registry. QoL (Euro-Qol-5D-index, German tariff) of a subset of patients known to be alive was assessed through postal surveys in 2006 (n=1022) and subsequently in 2011 (n=716). Mortality was tracked by the routine surveillance system of the AMI Registry. QALYs gained were calculated assuming a linear QoL change from baseline to follow-up. QoL trajectories of non-responders at follow-up and patients who died before follow-up were approximated by multiple imputation methods using the baseline QoL and covariate structure. Ordinary least square regression models were performed to quantify the QALYs and life years (LYs) lost over the mean observation time. RESULTS: Over a mean observation time of 4 years, patients with diabetes lost 0.14 LYs (3.75 vs. 3.89, p<0.01) and 0.36 QALYs (2.96 vs. 3.33, p<0.01) more than patients without diabetes. The QALY-gap was greatest for diabetic patients taking insulin (-0.66, p<0.01). Sensitivity analyses showed that models were robust concerning model assumptions.  CONCLUSIONS: The intermediate burden of diabetes for patients with CVD is substantial. Using individual-level data from population-based follow-up of studies is a valuable methodological extension to accurately quantify the burden of chronic conditions.