Youth Diabetes Rate Has Increased Substantially

The prevalence of type 2 diabetes increased 30.5% and the prevalence of type 1 diabetes increased 21.1% in US youth between 2001 and 2009, a study finds.

The prevalence of both type 1 and type 2 diabetes in US children and adolescents increased significantly from 2001 through 2009, according to the results of a large study published in the May 7, 2014, issue of the Journal of the American Medical Association.

The study estimated changes in the prevalence of type 1 and type 2 diabetes among more than 3 million children younger than 20 years of age overall and by population subgroups according to sex, age, and race and ethnicity. Data on all children diagnosed with type 1 or type 2 diabetes from 2001 to 2009 were collected from 5 centers located in California, Colorado, Ohio, South Carolina, and Washington State, as well as from selected American Indian reservations in Arizona and New Mexico. The prevalence of type 2 diabetes was only calculated for children aged 10 through 19 years, because not enough younger children were diagnosed with the disease to result in stable estimates.

Over the study period, the proportion of children diagnosed with both type 1 and type 2 diabetes significantly increased. From 2001 to 2008, the prevalence of type 1 diabetes, after adjustment, climbed from 1.60 to 1.94 per 1000, for an increase of 21.1%. When analyzed by subgroup, significant increases in type 1 diabetes were observed for both sexes, in children aged 5 years and older, and among all racial and ethnic subgroups except for American Indians. In 2009, the highest prevalence was estimated for white children, and the greatest increase in prevalence during the study period was observed in teens aged 15 to 19 years.

Although type 1 diabetes has been thought to primarily affect white children, these results suggest that the condition is becoming more common among minority children as well.

“The increase in prevalence among US minorities documented herein is of concern, given that minority youth are more likely to have poor glycemic control, known to be associated with the serious complications of type 1 diabetes,” the authors suggest.

The prevalence of type 2 diabetes also increased among multiple subgroups during the study period. After adjustment, the proportion of children diagnosed with type 2 diabetes rose from 0.37 to 0.48 per 1000 over the duration of the study, for an increase of 30.5%.

Significant increases in the prevalence of type 2 diabetes occurred in both sexes, among all age subgroups, and in white, black, and Hispanic children. The prevalence of type 2 diabetes was higher among adolescents aged 15 through 19 years compared with those aged 10 through 14 years, and was higher among girls than boys in both 2001 and 2009. Greater increases over time were also observed among these subgroups.

Increases in the prevalence of type 1 diabetes are most likely due to rising disease incidence, the authors note, while increases in type 2 diabetes prevalence may be due to changes in population risk, such as minority population growth, obesity, and exposure to diabetes in utero.