Rates of both type 1 and type 2 diabetes in people under age 20 have gone up significantly since 2001 in the United States, according to a new report published in the journal JAMA.
Researchers set out to find out whether rates of diabetes in youths had changed over the previous two decades, as well as to look for any differences in trends among subsets of young people from different racial or ethnic groups. They did this by studying data from numerous health care systems in six different areas of the United States, and comparing the numbers from each year between 2001 and 2017 (the last year for which data was available). This process included data from an average of 3.47 million youths each year.
Type 1, type 2 diabetes rates both increasing in youth
The researchers found that the rate of type 1 diabetes among U.S. youths ages 19 and younger increased significantly, from 1.48 per 1,000 youths in 2001 to 2.15 per 1,000 youths in 2017 — representing a 45% increase. And while the overall prevalence of type 2 diabetes was lower, the rate nearly doubled from 0.34 per 1,000 youths ages 10-19 in 2001, to 0.67 per 1,000 youths in 2017.
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When it came to racial or ethnic groups, the greatest increases in type 1 diabetes were seen in non-Hispanic white and non-Hispanic Black youths. The prevalence of type 1 increased by 0.93 per 1,000 among white youths, and by 0.89 per 1,000 among Black youths. For type 2 diabetes, the greatest increases were seen in non-Hispanic Black and Hispanic youths. The prevalence of type 2 increased by 0.85 per 1,000 among Black youths, and by 0.57 per 1,000 among Hispanic youths.
The researchers included race and ethnicity in this study “because of their association with diabetes prevalence” in past studies, and indeed found significant differences in diabetes rates — and how these rates changed — among different groups. Race and ethnicity were based mostly on self-reported information collected in a survey completed by parents, and medical records served as a second source for this information. Diabetes type was obtained from medical records.
Despite the overall trend of an increase in the rate of type 1 diabetes among youths, no increase was seen in those ages 4 or younger throughout the study period. For those ages 5-9, an increase was seen in Hispanic females and in white males and females. For those ages 10-14, an increase was seen in Asian or Pacific Islander, Black, Hispanic, and white males, and in American Indian females.
For type 2 diabetes, an increase among youths ages 10-14 was seen in Black males and females, and in Hispanic females. Among those ages 15-19, an increase was seen in females of all races or ethnicities except white, and in Black, Hispanic, and white males.
While this study didn’t look at the potential causes of the observed rise in diabetes prevalence, the researchers noted that contributing factors may include a higher rate of certain infections for type 1, and an increase in childhood obesity — along with greater pregnancy exposure to maternal obesity and diabetes — for type 2.
Want to learn more about diabetes in children? Read “The Type 1 Diabetes Diagnosis” and “Recognizing Type 2 Diabetes in Children and Adults.”