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Diabetes treatment in Germany aims not only to lower blood sugar but also to protect the blood vessels, eyes, kidneys and nerves. Diabetes is a long-term condition, and the patient is the main participant: every day, they or their family decide what to eat, how much insulin to take and how to prepare for exercise.
It is treated by endocrinologists and diabetologists (Diabetologe) in university hospitals, specialist centres and outpatient practices. This page covers tests, both types, complications, clinics and trip planning. Other hormone disorders are covered under endocrinology in Germany.
How diabetes is treated in Germany: tests come first
Treatment starts with tests that show the type of diabetes and whether organs are already affected. The key test, HbA1c, is an “average blood sugar” over recent months, so one meal does not change it. C-peptide shows how much insulin the pancreas still makes, and antibodies against its cells help tell type 1 from type 2. More on the diabetes diagnostics page.
The kidneys are checked too (filtration rate and protein in the urine), along with cholesterol and blood pressure. The doctor and patient then agree on goals together: a student with newly diagnosed diabetes needs different targets from an older person with heart disease.
Type 1 diabetes: insulin, sensors and pumps
Type 1 diabetes always needs insulin, because the immune system mistakenly destroys the insulin-producing cells of the pancreas. Basal-bolus therapy imitates the body: long-acting “background” insulin covers needs between meals and overnight, and fast-acting insulin is dosed for each meal according to carbohydrates and current glucose. More on the page about type 1 diabetes treatment.
Instead of finger pricks, many patients wear a continuous glucose monitoring (CGM) sensor that sends readings to a phone or pump and warns of falling glucose. When the pump is linked to the sensor, an algorithm reduces or pauses insulin as glucose drops and adds more as it rises: the so-called “artificial pancreas”. It helps most at night and during sport. It does not replace the patient, though: mealtime doses are usually entered by hand, sensors need changing, and if the system fails, the patient must switch to an insulin pen.
Diabetes education covers carbohydrate counting, dose changes before exercise, illness and travel. Children and teenagers are treated in dedicated centres, such as the Westend diabetes centre for children and adolescents at the German Red Cross hospitals in Berlin, led by Dr Silvia Müther. The centre fits pumps and sensors, trains the whole family, offers round-the-clock advice in emergencies and runs a transition programme to adult care. Islet cells grown from stem cells are still being tested in clinical trials and are not standard care. More in the article on stem cell therapy.
Type 2 diabetes: diet, tablets and newer medicines
Type 2 diabetes is treated in steps: diet, activity, weight loss and tablets prescribed by the doctor come first, then newer medicines and insulin if needed. The body still makes insulin, but muscles, liver and fat respond to it poorly, so lifestyle change remains the basis of treatment. Details on the page about type 2 diabetes treatment.
The newer medicines are mainly GLP-1 receptor agonists and SGLT-2 inhibitors. The first act like a gut hormone: they boost insulin release after meals, curb appetite and help with weight loss. The second make the kidneys pass excess glucose into the urine and support heart and kidney function; some are prescribed for heart failure and chronic kidney disease even without diabetes. Germany’s national care guideline for type 2 diabetes considers combining metformin with one of them when heart or vascular disease is present. In type 2, insulin is a normal tool when prescribed, not a “final stage”.
Bariatric surgery is considered when diabetes comes with severe obesity. The endocrinologist and the surgeon decide together after a work-up, weighing benefits, risks and the patient’s readiness for diet changes and long-term follow-up. Nobody can promise that diabetes will disappear after the operation.
Keeping complications in check
Regular eye, kidney and foot checks catch complications before symptoms appear. An ophthalmologist examines the retina through a dilated pupil; the feet are tested for sensation, and Doppler ultrasound checks blood flow in the leg arteries. Diabetic foot develops when nerves are damaged and circulation is poor, so a small wound goes unnoticed and heals badly. As the WHO diabetes fact sheet notes, this can cause foot ulcers and may lead to amputation, so any foot wound should be seen by a doctor promptly.
The heart and vessels need the same attention: blood pressure and cholesterol are monitored, and cardiac stress tests are ordered if indicated. With both diabetes and heart disease, a centre where diabetologists and cardiologists work under one roof and decide together makes sense.
Where diabetes is treated in Germany: clinics and doctors
Diabetes is treated both in specialist centres and in university hospitals. The Heart and Diabetes Center NRW (HDZ NRW) in Bad Oeynhausen is a specialist hospital for heart, circulatory and diabetes conditions and has been a university hospital of Ruhr University Bochum since 1989. At the m&i Specialty Clinic Bad Heilbrunn, Dr Andreas Liebl is head physician of the centre for diabetes and metabolic diseases. It treats all forms and stages of diabetes on its wards and is certified by the German Diabetes Society (DDG) as an Exzellenzzentrum. Dr Simone Eder sees patients in the clinic’s outpatient diabetology practice.
Several university hospitals have dedicated endocrinology and diabetology clinics: in Essen, the Klinik für Endokrinologie, Diabetologie und Stoffwechsel; in Düsseldorf, the Klinik für Endokrinologie und Diabetologie, which treats all forms of diabetes, both outpatient and inpatient. At University Hospital Dresden, Prof. Nikolaos Perakakis heads metabolic-vascular medicine. University Hospital Regensburg runs a nutrition and diabetes counselling centre (ZED). The hospital decides which doctor sees the patient.
Frequently asked questions
Where is the best place to treat diabetes?
No single clinic suits everyone: the choice depends on the task. A first guide is certification by the German Diabetes Society (DDG), given to hospitals and practices that follow clinical guidelines, run structured patient education and monitor complications. Then check experience with your type of diabetes and with pumps, and access to foot, kidney and heart specialists.
What is the new diabetes medicine called?
There is no single “new medicine”: the phrase covers several drug groups. These include GLP-1 receptor agonists such as semaglutide, and tirzepatide, which acts like two gut hormones, GIP and GLP-1. SGLT-2 inhibitors are also fairly new, and the EU has approved a long-acting insulin injected once a week. The doctor decides which, if any, suits a patient.
How much does diabetes treatment in Germany cost?
There is no fixed price: the cost depends on the task, such as tests, therapy adjustment, pump set-up, diabetic foot care or surgery preparation, and on whether a hospital stay is needed. The hospital states the exact amount in its cost estimate (Kostenvoranschlag) after reviewing the patient’s records, so these are gathered first.
How AlenMed arranges diabetes treatment in Germany
AlenMed starts with the documents: discharge letters, recent lab results, sensor data or a blood sugar diary, the pump report if there is one, and a list of all medicines with doses. We translate them into German so the hospital can assess the case before the trip.
We choose the hospital to match the task: adjusting therapy, setting up a pump, treating complications or preparing for surgery. The hospital sends a cost estimate (Kostenvoranschlag); once it is agreed, we help with the visa invitation, and a medical interpreter joins the patient at appointments. AlenMed’s office is in Munich, with 86 partner hospitals in 38 cities across Germany.
This page is general information, not an offer. A doctor sets the treatment plan at an in-person consultation; the final cost is in the hospital’s estimate.
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