The prevalence of Type 1 diabetes and Type 2 diabetes jumped by 21% and 30%, respectively, in US youth over an eight-year period, according to new data from the SEARCH for Diabetes in Youth Study. An estimated 215,000 Americans under the age of 20 have been diagnosed with diabetes, according to the National Diabetes Education Program.
Type 1 diabetes is an autoimmune disorder in which the immune system attacks the insulin-producing cells in the pancreas, causing it to secrete little or no insulin. Type 2 diabetes is defined by insulin resistance, a condition in which the body does not use insulin efficiently, and insufficient insulin secretion by the pancreas.
To estimate changes in the prevalence of Type 1 and Type 2 diabetes in youth in the United States, researchers collected data from more than three million children and adolescents seen at centers in California, Colorado, Ohio, South Carolina, and Washington state, as well as on American Indian reservations in Arizona and New Mexico. The data was collected between 2001 and 2009 and included cases of doctor-diagnosed Type 1 diabetes in children ages 0–19 and Type 2 diabetes in children ages 10–19.
In 2001, the prevalence of Type 1 among the study subjects was 1.48 per 1,000, which had increased to 1.93 per 1,000 by 2009. After adjustment, this represented a 21% increase in the condition over the eight-year study period. The greatest increase was seen in adolescents 15–19 years old. The rise was not confined only to the traditional at-risk group of white adolescents, but rather was seen in children and adolescents of white, black, Hispanic, and Asian Pacific Islander descent.
“I don’t understand the basis for an increase,” said Robin S. Goland, MD, of the Naomi Berrie Diabetes Center, who was not involved in the research. “There are a few possibilities, but we need to figure it out if it’s something in the environment or something in our genes.”
The prevalence of Type 2 diabetes in the study population was 0.34 per 1,000 in 2001, increasing to 0.46 per 1,000 in 2009, representing an increase of roughly 30.5% in eight years. A significant increase was seen across all age groups and in white, black, and Hispanic youth. This rise was likely attributable to the obesity epidemic and the long-term impact of higher rates of gestational diabetes, according to the researchers.
“Our study is really the first in the US to quantify the burden of Type 2 diabetes at the population level — and not just in a clinic or group of clinics, [but] in all major racial/ethnic groups in the US — and documents increasing trends in several racial-ethnic groups,” said lead study author Dana Dabelea, MD, PhD.
The rise in diabetes cases in youth is important, the researchers observed, because these children will enter adulthood with several years of diabetes duration and an increased risk of early complications. The youth will also have diabetes during their childbearing years, which could increase the diabetes rate in the next generation.
Further study is needed to address the cause of the increases in Type 1 and Type 2, the study authors note.
Because the study ended in 2009, it cannot provide information about diabetes trends in youth over the past five years. Also, because it included only children and adolescents who had been diagnosed with diabetes by a physician, it may have missed those who would have met the criteria for the condition had they been screened.
For more information, read the article “Large increase in type 1, 2 diabetes among US youth, study shows” or see the study in Journal of the American Medical Association. And for more about diabetes in children, click here.
What do you believe accounts for the increasing rates of Type 1 and Type 2 diabetes in American youth? Let us know with a comment.
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Diane Fennell: Diane Fennell has been an editor at Diabetes Self-Management magazine since 2003. She is currently the Editorial Director. (Diane Fennell is not a medical professional.)
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