Abstract Knowledge of the severity distribution (SD) of certain diseases is crucial for calculating the years lost due to disability (YLD), as the time spent with a disease is explicitly weighted on the health state level. Depending on the disease, different severity levels are considered. In most cases, the SDs vary from mild, moderate, severe to most severe. This is different in the context of diabetes, where an explicit distinction is made according to the sequelae resulting from the disease progression. In general, these include diabetic neuropathy (with foot ulcers or amputations) and (mild or moderate) vision impairments including blindness due to diabetic retinopathy. These complications cause a considerable loss of quality of life for those affected and high costs for the healthcare system. However, the progression of many of the sequelae can be avoided through (secondary) preventive measures. Estimating the degree of severity is therefore an important indicator of the population affected and in need for care. Due to a lack of data, the Global Burden of Disease Study often uses time-invariant and regionally fixed SDs. Important insights as to the temporal variance of SDs thus remain unnoticed. As part of the BURDEN 2020 pilot project in Germany, SD for diabetes-related complications were estimated from routine health insurance data for the year 2017. In a follow-up project (BURDEN 2.0), these results will also be available for the years 2017 to 2022. If there are any changes in the proportion of individual health conditions, implications can be generated from routine healthcare data of those affected. The SDs overall and according to certain sequelae will be presented over time and discussed. Also, the resulting YLD over time for type 2 diabetes will be examined, including changes in the prevalence of the disease. This makes it possible to analyse and interpret the burden of disease due to diabetes during the years 2017 to 2022.